Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty
Abstract Background The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. Methods Pati...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03455-3 |
| _version_ | 1818760071111245824 |
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| author | Jorge Arias-de la Torre Kayla Smith Alexandru Dregan Jose M. Valderas Jonathan P. Evans Daniel Prieto-Alhambra Luis Lozano Antonio J. Molina Vicente Martín Laia Domingo Laura Muñoz Mireia Espallargues |
| author_facet | Jorge Arias-de la Torre Kayla Smith Alexandru Dregan Jose M. Valderas Jonathan P. Evans Daniel Prieto-Alhambra Luis Lozano Antonio J. Molina Vicente Martín Laia Domingo Laura Muñoz Mireia Espallargues |
| author_sort | Jorge Arias-de la Torre |
| collection | DOAJ |
| description | Abstract Background The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. Methods Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years’ follow-up was calculated, and adjusted Competing Risks models were fitted. Results A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses. Conclusions Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA. |
| first_indexed | 2024-12-18T06:52:47Z |
| format | Article |
| id | doaj.art-3b39c532aae344e58a737a2ee91ee3fb |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-18T06:52:47Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3b39c532aae344e58a737a2ee91ee3fb2022-12-21T21:17:16ZengBMCBMC Musculoskeletal Disorders1471-24742020-07-0121111210.1186/s12891-020-03455-3Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplastyJorge Arias-de la Torre0Kayla Smith1Alexandru Dregan2Jose M. Valderas3Jonathan P. Evans4Daniel Prieto-Alhambra5Luis Lozano6Antonio J. Molina7Vicente Martín8Laia Domingo9Laura Muñoz10Mireia Espallargues11Agency for Heath Quality and Assessment of Catalonia (AQuAS)Agency for Heath Quality and Assessment of Catalonia (AQuAS)King’s College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN)Health Services and Policy Research Group, University of Exeter Medical SchoolHealth Services and Policy Research Group, University of Exeter Medical SchoolOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of OxfordHospital Clinic de BarcelonaCIBER Epidemiology and Public Health (CIBERESP)CIBER Epidemiology and Public Health (CIBERESP)Health Services Research on Chronic Patients Network (REDISSEC)Agency for Heath Quality and Assessment of Catalonia (AQuAS)Agency for Heath Quality and Assessment of Catalonia (AQuAS)Abstract Background The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. Methods Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years’ follow-up was calculated, and adjusted Competing Risks models were fitted. Results A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses. Conclusions Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.http://link.springer.com/article/10.1186/s12891-020-03455-3Total knee arthroplastyTotal hip arthroplastyComorbidityArthroplasty revisionRegister studies |
| spellingShingle | Jorge Arias-de la Torre Kayla Smith Alexandru Dregan Jose M. Valderas Jonathan P. Evans Daniel Prieto-Alhambra Luis Lozano Antonio J. Molina Vicente Martín Laia Domingo Laura Muñoz Mireia Espallargues Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty BMC Musculoskeletal Disorders Total knee arthroplasty Total hip arthroplasty Comorbidity Arthroplasty revision Register studies |
| title | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
| title_full | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
| title_fullStr | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
| title_full_unstemmed | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
| title_short | Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty |
| title_sort | impact of comorbidity on the short and medium term risk of revision in total hip and knee arthroplasty |
| topic | Total knee arthroplasty Total hip arthroplasty Comorbidity Arthroplasty revision Register studies |
| url | http://link.springer.com/article/10.1186/s12891-020-03455-3 |
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