Higher risk of complications after TKA found for post-traumatic arthritis vs OA
Results of a study comparing outcomes of total knee arthroplasty procedures performed for osteoarthritis and post-traumatic arthritis have shown the incidence of superficial wound infection, deep joint infection and acute deep venous thrombosis occurs at a higher rate in patients with post-traumatic arthritis. However, the incidence of pulmonary embolus was not statistically different between the two groups.
Investigators used the National Inpatient Sample Database to identify 1,301,394 patients with either post-traumatic arthritis or OA who underwent TKA between 2006 and 2015. Overall, 1,4206 patients had post-traumatic arthritis and 1,287,188 had OA.
Superficial wound infections occurred in 0.3% of patients with post-traumatic arthritis vs. 0.14% of patients with OA. Deep joint infections occurred in 0.21% of the post-traumatic arthritis group vs. 0.13% of patients with OA and acute venous embolism and thrombosis were found in 0.53% of patients with post-traumatic arthritis vs. 0.38% of patients with OA. Rate of pulmonary embolus was similar with 0.10% in the post-traumatic arthritis group vs. 0.15% in the OA group
Investigators also found patients with post-traumatic arthritis had a higher prevalence of drug and alcohol abuse, psychosis and liver disease. Patients with OA had a higher prevalence of obesity, diabetes, heart disease and lung disease.
“The specific factors that create these differences are undoubtedly complex and multifactorial,” the authors wrote. “Patients with [post-traumatic arthritis] PTA of the knee, either tibial or femoral in origin, will often have distorted bony anatomy due to fracture healing. Many patients will have had one or more previous procedures which can lead to a disruption of the normal tissue planes and possibly necessitate the surgeon to perform an alternative surgical approach compared to a native knee.”
The authors of this noted variables that could contribute to the different outcomes between the groups include length of operative time, abuse of mind-altering substances, missed follow-up appointments, mental illnesses and repeat traumatic events. - by Serenity Bishop
Disclosures: The authors report no relevant financial funding