According to an article in The Journal of Arthroplasty, a potential association between psoriasis and post-surgical complications after total knee arthroplasty (TKA) has not been investigated. Researchers, led by Peter A. Gold, from the Long Island Jewish Medical Center in New York, performed a study to reveal whether patients with psoriasis have unique demographics or comorbidities after TKA compared to patients without psoriasis. The study’s contributors concluded that the presence of psoriasis “warrants increased pre-operative counseling, shared decision making, and infectious precautions in the TKA population.”

Researchers assessed a cohort of 10,727 patients from an institutional database who were undergoing primary TKA, among which 133 had psoriasis. The primary post-operative complications analyzed were wound complications, cellulitic episodes, and deep surgical site infections (SSIs). The data were adjusted for age and various comorbidities and results of the patients with psoriasis were compared to those without to determine associated risks.

The study found that patients with psoriasis had an increased associated risk of deep surgical site infections (3.8%) compared to patients without psoriasis (1.2%; p = 0.023). Moreover, the authors reported that “multivariate analyses demonstrated a significant associated risk of deep SSIs (odds ratio [OR] = 7.04; 95% confidence interval [CI], 2.38–20.9; p <0.001) and wound complications (OR = 4.44; 95%, 1.02–19.2; p = 0.047).

In closing, the authors advised that “increased vigilance is required given the coexistence of certain comorbidities with this population, including depression, substance use disorder, smoking history, gastroesophageal reflux disease, and inflammatory bowel disease.”