Juvenile Idiopathic Arthritis is Associated With Early Medical and Surgical Complications Following Primary Total Hip Arthroplasty: A National Database Study

Sean B. Sequeira, MD; Brian P. McCormick, MD; Mark D. Hasenauer, MD; Robert McKinstry, MD; Frank Ebert, MD; Henry R. Boucher, MD

Arthroplasty Today (Apr 2024)

Juvenile Idiopathic Arthritis is Associated With Early Medical and Surgical Complications Following Primary Total Hip Arthroplasty: A National Database Study

Sean B. Sequeira, MD,
Brian P. McCormick, MD,
Mark D. Hasenauer, MD,
Robert McKinstry, MD,
Frank Ebert, MD,
Henry R. Boucher, MD

Affiliations

Sean B. Sequeira, MD: Corresponding author. Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 3333 North Calvert Street, Suite 400, Baltimore, MD 21218, USA. Tel.: +1 (410) 554-2000.; Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
Brian P. McCormick, MD: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
Mark D. Hasenauer, MD: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
Robert McKinstry, MD: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
Frank Ebert, MD: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
Henry R. Boucher, MD: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA

Journal volume & issue: Vol. 26
p. 101289

Abstract

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Background: Juvenile idiopathic arthritis (JIA) is an inflammatory arthropathy that classically affects children but can cause long-term deformity to the femoral head and hip joint, which may require an arthroplasty procedure. There is a paucity of data surrounding the medical and surgical outcomes of total hip arthroplasty (THA) in patients with JIA compared to a control cohort. Methods: Patients with JIA who underwent THA from 2010 to 2019 were identified in a large national insurance database. A propensity score matching algorithm was used to obtain a control cohort who did not have JIA based upon age, sex, and Elixhauser Comorbidity Index in a 1:10 ratio. Seven hundred sixty-three patients with JIA and 7434 patients without JIA were identified who underwent THA. Ninety-day medical outcomes, 1-year surgical outcomes, and 90-day return to the emergency department and readmission were calculated. Results: Patients with JIA were at increased risk of 90-day transfusion (odds ratio [OR] 1.79; P < .001), pneumonia (OR 2.68; P < .001), urinary tract infection (OR 2.64; P < .001), and wound disruption (OR 2.72; P < .001), as well as 1-year risk of revision THA (OR 2.27; P < .001), periprosthetic joint infection (OR 2.98; P < .001), periprosthetic fracture (OR 2.93; P < .001), aseptic loosening (OR 3.92; P < .001), dislocation (OR 2.61; P = .001), and debridement, antibiotics, and implant retention procedure (OR 2.71; P < .001). Patients with JIA were also at increased risk of 90-day emergency department visit (OR 2.54; P < .001) and readmission (OR 2.59; P < .001). Conclusions: Patients with JIA were at increased risk of early medical and surgical complications following THA. These findings are imperative for surgeons to consider and may warrant tailored perioperative decision-making to avoid the aforementioned medical and surgical complications.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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