Inflammatory Diseases and Complications After Total Hip Arthroplasty

In a study published in BMC Musculoskeletal Disorders, researchers compared perioperative complications after total hip arthroplasty (THA) among patients with primary osteoarthritis (OA) or different inflammatory disease subtypes. The authors found patients with rheumatoid arthritis (RA) had elevated complications after THA, while postoperative differences among OA and other inflammatory subtypes were small.

The study enrolled 17,200 patients with RA, 941 with ankylosing spondylitis (AS), 962 with psoriatic arthritis (PsA), and 509,426 primary OA controls from the National Inpatient Sample database who underwent unilateral THA from 2005 to 2014.

According to the report, patients with RA had significantly greater incidences of postoperative medical and surgical complications compared with patients with primary OA. Specifically, patients with RA were more likely to have blood transfusions, mechanical prosthesis joint complications, periprosthetic joint and other postoperative infections, urinary tract infections, and acute cardiac events. In addition, patients in the psoriatic arthritis group had numerically greater incidences of acute renal failure and stroke compared with the primary OA group.

The authors noted their findings were limited by the relatively small subgroups for other inflammatory diseases and also because the data were based on the International Classification of Diseases Clinical Modification version 9 codes instead of the updated version 10 codes.

The authors concluded that patients with primary OA, AS, and PsA had relatively similar rates of disease subtypes, while those with RA had significantly higher incidences of complications after THA.

Reference: Lian Q, Lian Y, Li K, et al. Complications of primary total hip arthroplasty among patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and primary osteoarthritis. BMC Musculoskelet Disord. 2022;23(1):924. doi:10.1186/s12891-022-05891-9

Link: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-05891-9