Preoperative demographics and laboratory markers may be associated with early dislocation after total hip arthroplasty.
Frailty
Medical optimization
Postoperative complication
Prosthetic dislocation
Total hip arthroplasty
Journal
Journal of experimental orthopaedics
ISSN: 2197-1153
Titre abrégé: J Exp Orthop
Pays: Germany
ID NLM: 101653750
Informations de publication
Date de publication:
06 Oct 2023
06 Oct 2023
Historique:
received:
05
03
2023
accepted:
18
09
2023
medline:
6
10
2023
pubmed:
6
10
2023
entrez:
6
10
2023
Statut:
epublish
Résumé
The purpose of this study was to identify modifiable medical comorbidities, laboratory markers and flaws in perioperative management that increase the risk of acute dislocation in total hip arthroplasty (THA) patients. All THA with primary indications of osteoarthritis from 2007 to 2020 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Demographic data, preoperative laboratory values, recorded past medical history, operative details as well as outcome and complication information were collected. The study population was divided into two cohorts: non-dislocation and dislocation patients. Statistics were performed to compare the characteristics of both cohorts and to identify risk factors for prosthetic dislocation (α < 0.05). 275,107 patients underwent primary THA in 2007 to 2020, of which 1,258 (0.5%) patients experienced a prosthetic hip dislocation. Demographics between non-dislocation and dislocation cohorts varied significantly in that dislocation patients were more likely to be female, older, with lower body mass index and a more extensive past medical history (all p < 0.05). Moreover, hypoalbuminemia and moderate/severe anemia were associated with increased risk of dislocation in a multivariate model (all p < 0.05). Finally, use of general anesthesia, longer operative time, and longer length of hospital stay correlated with greater risk of prosthetic dislocation (all p < 0.05). Elderly female patients and patients with certain abnormal preoperative laboratory values are at risk for sustaining acute dislocations after index THA. Careful interdisciplinary planning and medical optimization should be considered in high-risk patients as dislocations significantly increase the risk of sepsis, cerebral vascular accident, and blood transfusions on readmission.
Identifiants
pubmed: 37801165
doi: 10.1186/s40634-023-00659-z
pii: 10.1186/s40634-023-00659-z
pmc: PMC10558409
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100Informations de copyright
© 2023. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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