Total Joint Arthroplasty in Immunocompromised Patients

A Matched Pair Analysis for Comorbidities

Morteza Meftah, MD; Grace Plassche, BS; Ariel Silverman, BS; Peter B. White, BS; Ira H. Kirschenbaum, MD

Disclosures

Curr Orthop Pract. 2019;30(3):246-249. 

In This Article

Results

The mean follow-up was 3.1±1.5 yr (range, 2–5). The overall complication rate in the IC group and N-IC groups was 20% (22 patients) and 14.6% (16 patients), respectively, which was not statistically significant (P=0.34, Table 2). There were no differences between the two groups in the incidence of deep or superficial infection, other complications, or readmissions. However, there was a significant difference for reoperation (16 vs. 6, P=0.04). There was also no significant difference between the two groups regarding illicit cocaine and opioid abuse between IC (28, 25.6%) and N-IC (26, 23.9%), P=0.87. There was no difference overall for preoperative diabetes or smoking (Table 3).

Superficial and deep infection were found in 2.1% (four patients) and 5.5% (six patients) in the IC group, versus 0.9% (one patient) and 2.7% (three patients) in the N-IC group, respectively, none were statistically significant. Both groups had 11% other complications, such as acute renal failure, cardiopulmonary event, urinary tract infection, periprosthetic fracture, manipulation under anesthesia, or deep venous thrombosis (Table 2).

Sixteen patients (14.7%) in the IC group required a revision or reoperation versus six patients (5.5%) in the N-IC group, which was statistically significant. The most common reasons for reoperation in the IC group was infection (n=6), stiffness (n=4), and wound dehiscence (n=4) (Table 2). We found no correlation between any patient factors (age, BMI, gender, procedure, smoking, diabetes) and outcomes (infection, readmission or reoperation).

When data were adjusted for confounding factors for complications, matched for comorbidities, including diabetes in 66 patients, the rates of infection and reoperation were 7.5% (five patients) and 4.5% (three patients) in IC and 9% (six patients) and 6% (four patients) in N-IC groups, respectively (Table 4), which were not statistically significant.

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