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. 2020 Jul 9;21(1):447.
doi: 10.1186/s12891-020-03455-3.

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

Jorge Arias-de la Torre  1   2   3   4 , Kayla Smith  5   6 , Alexandru Dregan  7 , Jose M Valderas  8 , Jonathan P Evans  8   9 , Daniel Prieto-Alhambra  10 , Luis Lozano  11 , Antonio J Molina  12 , Vicente Martín  12   13 , Laia Domingo  6   14 , Laura Muñoz  5   6 , Mireia Espallargues  5   6
Affiliations

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

Jorge Arias-de la Torre et al. BMC Musculoskelet Disord. .

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.

Keywords: Arthroplasty revision; Comorbidity; Register studies; Total hip arthroplasty; Total knee arthroplasty.

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Conflict of interest statement

All authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Selection of the study sample
Fig. 2
Fig. 2
Incidence of revision by burden of comorbidity in TKA
Fig. 3
Fig. 3
Incidence of revision by burden of comorbidity in THA
See this image and copyright information in PMC

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