The effects of multiple myeloma on total knee arthroplasty outcomes: A retrospective study

Abstract

Background: Total knee arthroplasty (TKA) is a common orthopedic procedure, yet outcomes in patients with multiple myeloma (MM) remain poorly understood since there are limited studies. As a result, the aim was to assess how MM affects outcomes of patients undergoing TKA.

Methods: In this retrospective cohort study, patients with MM who underwent TKA were identified using a TriNetX national database from 2005 to 2024. These patients were matched to controls without MM using propensity score matching based on age, sex and relevant comorbidities. Postoperative complication rates, readmission, revision surgery, and mortality were analyzed over a one-year follow-up.

Results: A total of 237, 007 patients who had TKR were matched to 353 patients with MM who had TKR. MM patients were older, male (mean age 70.3 vs 67 years) and had a higher incidence of comorbidities at baseline. MM patients had significantly higher rates of wound dehiscence (1.98 % vs 0.52 %, p = .003), periprosthetic infection (2.27 % vs 0.81 %, p = .009), acute renal failure (5.95 % vs 1.96 %, p < .001), blood loss anemia (15.01 % vs 6.53 %, p < .001),DVT (2.55 % vs 1.27 p = .049), myocardial infarction (0.85 % vs 0.21 %, p = .040), pulmonary embolism (3.12 % vs 0.84 %, p < .001) and pneumonia. However, one-year mortality rates did not differ significantly between groups.

Conclusion: MM is associated with an increased risk of postoperative complications following TKA compared to control patients but not mortality. This study highlights multispecialty tailored perioperative care protocols for MM patients undergoing TKA to decrease complications.

Keywords: Arthroplasty; Knee; Multiple Myeloma; Postoperative Complications; Replacement; Retrospective Studies; Risk Factors; Treatment Outcome.