Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival

Background: Achondroplasia is the most common skeletal dysplasia, and total joint arthroplasty of the hip and/or knee in this patient population may present unique challenges. Methods: All patients undergoing primary total hip or total knee arthroplasty (THA or TKA) for osteoarthritis in the 2010-20...

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Autores principales:	Harold G. Moore, BS, Christopher A. Schneble, MD, Joseph B. Kahan, MD, MPH, Gregory G. Polkowski, MD, MSc, Lee E. Rubin, MD, Jonathan N. Grauer, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/13c887c9b43943809dad3240bf818c90
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spelling	oai:doaj.org-article:13c887c9b43943809dad3240bf818c902021-11-14T04:34:02ZTotal Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival2352-344110.1016/j.artd.2021.08.011https://doaj.org/article/13c887c9b43943809dad3240bf818c902021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001527https://doaj.org/toc/2352-3441Background: Achondroplasia is the most common skeletal dysplasia, and total joint arthroplasty of the hip and/or knee in this patient population may present unique challenges. Methods: All patients undergoing primary total hip or total knee arthroplasty (THA or TKA) for osteoarthritis in the 2010-2019 PearlDiver Mariner administrative database with least 90 days of postoperative follow-up were identified. Those with achondroplasia were matched 1:10 to patients without achondroplasia based on age, sex, and medical comorbidities. Ninety-day adverse events were assessed and compared using multivariate logistic regression. Five-year implant survival was determined and compared with Kaplan-Meier implant survival curves. Significance was set at P < .05. Results: For THA, 150 patients with achondroplasia were matched to 1484 patients without and had significantly higher 90 days odds of surgical site infection (odds ratio [OR] = 3.49, P = .005) and readmission (OR = 2.35, P = .016). For TKA, 285 patients with achondroplasia were matched to 2828 without and had higher odds of aggregated any adverse event (OR = 1.52, P = .006) and transfusion (OR = 2.31, P < .001). Rates of the other studied adverse events were not significant for either set of the analyses. At 5 years, implant survival for those with and without achondroplasia was not different for those undergoing THA (P = .321) or TKA (P = .910). Conclusions: The present study represents the largest cohort of patients with achondroplasia undergoing total joint arthroplasty to date. Although several short-term adverse events had greater odds for those with achondroplasia, 5-year survival was not different for those with or without achondroplasia after THA or TKA, supporting confidence in longer term implant success.Harold G. Moore, BSChristopher A. Schneble, MDJoseph B. Kahan, MD, MPHGregory G. Polkowski, MD, MScLee E. Rubin, MDJonathan N. Grauer, MDElsevierarticleOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 151-156 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Harold G. Moore, BS Christopher A. Schneble, MD Joseph B. Kahan, MD, MPH Gregory G. Polkowski, MD, MSc Lee E. Rubin, MD Jonathan N. Grauer, MD Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
description	Background: Achondroplasia is the most common skeletal dysplasia, and total joint arthroplasty of the hip and/or knee in this patient population may present unique challenges. Methods: All patients undergoing primary total hip or total knee arthroplasty (THA or TKA) for osteoarthritis in the 2010-2019 PearlDiver Mariner administrative database with least 90 days of postoperative follow-up were identified. Those with achondroplasia were matched 1:10 to patients without achondroplasia based on age, sex, and medical comorbidities. Ninety-day adverse events were assessed and compared using multivariate logistic regression. Five-year implant survival was determined and compared with Kaplan-Meier implant survival curves. Significance was set at P < .05. Results: For THA, 150 patients with achondroplasia were matched to 1484 patients without and had significantly higher 90 days odds of surgical site infection (odds ratio [OR] = 3.49, P = .005) and readmission (OR = 2.35, P = .016). For TKA, 285 patients with achondroplasia were matched to 2828 without and had higher odds of aggregated any adverse event (OR = 1.52, P = .006) and transfusion (OR = 2.31, P < .001). Rates of the other studied adverse events were not significant for either set of the analyses. At 5 years, implant survival for those with and without achondroplasia was not different for those undergoing THA (P = .321) or TKA (P = .910). Conclusions: The present study represents the largest cohort of patients with achondroplasia undergoing total joint arthroplasty to date. Although several short-term adverse events had greater odds for those with achondroplasia, 5-year survival was not different for those with or without achondroplasia after THA or TKA, supporting confidence in longer term implant success.
format	article
author	Harold G. Moore, BS Christopher A. Schneble, MD Joseph B. Kahan, MD, MPH Gregory G. Polkowski, MD, MSc Lee E. Rubin, MD Jonathan N. Grauer, MD
author_facet	Harold G. Moore, BS Christopher A. Schneble, MD Joseph B. Kahan, MD, MPH Gregory G. Polkowski, MD, MSc Lee E. Rubin, MD Jonathan N. Grauer, MD
author_sort	Harold G. Moore, BS
title	Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
title_short	Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
title_full	Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
title_fullStr	Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
title_full_unstemmed	Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival
title_sort	total joint arthroplasty in patients with achondroplasia: comparison of 90-day adverse events and 5-year implant survival
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/13c887c9b43943809dad3240bf818c90
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Total Joint Arthroplasty in Patients With Achondroplasia: Comparison of 90-Day Adverse Events and 5-Year Implant Survival

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