Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;38(7 Suppl 2):S111-S115.
doi: 10.1016/j.arth.2023.04.043. Epub 2023 Apr 25.

Higher Complication Rate in COVID-19 Recovered Patients Undergoing Primary Total Joint Arthroplasty

Anderson Lee  1 , Caleb R Durst  1 , Kevin T Rezzadeh  2 , Sean S Rajaee  1 , Brad L Penenberg  1 , Justin P Than  1
Affiliations

Higher Complication Rate in COVID-19 Recovered Patients Undergoing Primary Total Joint Arthroplasty

Anderson Lee et al. J Arthroplasty. 2023 Jul.

Abstract

Background: There is limited data reviewing complication risks associated with total joint arthroplasty (TJA) after recovering from COVID-19. This study evaluated complications within 90 days of TJA in patients who had a COVID-19 diagnosis at varying intervals prior to surgery versus a non-COVID-19 cohort.

Methods: A large national database was used to identify patients diagnosed with COVID-19 in the six months prior to total hip arthroplasty (THA) or total knee arthroplasty. The incidence of complications within 90 days of surgery was recorded and compared to a COVID-19 negative control group matched 1:3 for age range in 5-year intervals, Charlson Comorbidity Index, and sex. There were 7,780 patients included in the study; 5,840 (75.1%) never diagnosed with COVID-19, 1,390 (17.9%) who had a COVID-19 diagnosis 0 to 3 months prior to surgery, and 550 (7.1%) who had a COVID-19 diagnosis 3 to 6 months prior to surgery.

Results: When compared to their COVID negative controls, patients who had a COVID-19 diagnosis 0 to 3 months prior to surgery had significantly higher rates of readmission (14.0 versus 11.1%, P = .001), pneumonia (2.2 versus 0.7%, P < .001), deep vein thrombosis (DVT) (3.3 versus 1.9%, P = .001), kidney failure (2.4 versus 1.4%, P = .006), and acute respiratory distress syndrome (1.4 versus 0.7%, P = .01). Patients who had a COVID-19 diagnosis 3 to 6 months prior to surgery had significantly higher rates of pneumonia (2.0 versus 0.7%, P = .002) and DVT (3.6 versus 1.9%, P = .005) when compared to their COVID negative controls.

Conclusion: Patients diagnosed with COVID-19 within three months prior to TJA have an increased risk of 90-day postoperative complications. Risk for pneumonia and DVT remains elevated even when surgery was performed as far as 3 to 6 months after COVID-19 diagnosis.

Keywords: COVID-19; perioperative complications; total hip arthroplasty; total joint arthoplasty; total knee arthroplasty.

PubMed Disclaimer

References

    1. Centers for Disease Control and Prevention CDC museum COVID-19 timeline. https://www.cdc.gov/museum/timeline/covid19.html
    1. COVIDSurg Collaborative Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107:1440–1449. doi: 10.1002/bjs.11746. - DOI - PMC - PubMed
    1. The Lancet Rheumatology Too long to wait: the impact of COVID-19 on elective surgery. Lancet Rheumatol. 2021;3:e83. doi: 10.1016/S2665-9913(21)00001-1. - DOI - PMC - PubMed
    1. Bedard N.A., Elkins J.M., Brown T.S. Effect of COVID-19 on hip and knee arthroplasty surgical volume in the United States. J Arthroplasty. 2020;35:S45–S48. doi: 10.1016/j.arth.2020.04.060. - DOI - PMC - PubMed
    1. O'Connor C.M., Anoushiravani A.A., DiCaprio M.R., Healy W.L., Iorio R. Economic recovery after the COVID-19 pandemic: resuming elective orthopedic surgery and total joint arthroplasty. J Arthroplasty. 2020;35:S32–S36. doi: 10.1016/j.arth.2020.04.038. - DOI - PMC - PubMed

MeSH terms