gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)

24.10. - 27.10.2017, Berlin

Is AVN due to systemic lupus erythematous associated with increased risk of complications following THA?

Meeting Abstract

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  • presenting/speaker Quanjun Cui - University of Virginia, Department of Orthopaedics, Charlottesville, United States
  • Jourdan Cancienne - University of Virginia, Department of Orthopaedics, Charlottesville, United States
  • Brian Werner - University of Virginia, Department of Orthopaedics, Charlottesville, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN33-561

doi: 10.3205/17dkou083, urn:nbn:de:0183-17dkou0834

Veröffentlicht: 23. Oktober 2017

© 2017 Cui et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: As the medical treatment of systemic lupus erythematosus (SLE) has evolved, the rate of total hip arthroplasty (THA) has increased. While avascular necrosis (AVN) has long been the primary indication for arthroplasty in patients with SLE, non AVN diagnoses now predominate. Literature comparing THA in patients with SLE for AVN vs non-AVN and patients with AVN due to other conditions is limited. The goal of the present study was to use a national database to investigate the current trend in SLE patients undergoing THA and compare complications following THA for AVN in patients with SLE, without SLE, and osteoarthritis (OA).

Methods: Patients who underwent primary THA for AVN with SLE (n=244) were identified in the database from 2007 to 2015 using ICD-9 procedure and diagnostic coding. Control cohorts of patients undergoing THA for AVN due to non-SLE diagnoses (n=7,836) and OA without SLE (n=64,235) were created for comparison purposes. Patients in each cohort were then queried for postoperative deep vein thrombosis (DVT), infection, blood transfusion, medical complications, dislocation, and readmission within 90 days, in addition to overall dislocation and revision surgery rates using ICD-9 and CPT coding. Complication rates were compared using a multivariate analysis controlling for gender, age, obesity, tobacco use, alcohol use, inflammatory arthritis, depression, and several other comorbidities.

Results and Conclusion: The number of THA in patients with SLE increased 190% over the time period studied (Figure 1 [Fig. 1]). Patients with SLE undergoing THA for AVN experienced lower rates of all measured postoperative complications compared to patients undergoing THA for non-SLE related AVN diagnoses, including significantly lower rates of infection and medical complications within 90 days (Table 1 [Tab. 1]). Compared to patients without SLE undergoing THA for OA, SLE patients undergoing THA for AVN experienced significantly higher rates of blood transfusion and medical complications, and significantly lower rates of infection within 90 days (Table 2 [Tab. 2]). There were no other significant differences in complications noted between these two cohorts.

In this large database study, patients with SLE undergoing THA for AVN experienced similar rates of post-operative complications compared to patients undergoing THA for non-SLE AVN diagnoses. Patients with SLE undergoing THA for AVN also experienced similar complications rates compared to those undergoing THA for OA, with the exception of increased transfusion and medical complication rates.