Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study
Background: Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article see...
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Elsevier
2024-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124001973 |
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| author | Christian DeMaio, BS Conner Patrick, MD Grayson Domingue, MD Jake Fox, MD Justin Dvorak, PhD Rishi Thakral, MD |
| author_facet | Christian DeMaio, BS Conner Patrick, MD Grayson Domingue, MD Jake Fox, MD Justin Dvorak, PhD Rishi Thakral, MD |
| author_sort | Christian DeMaio, BS |
| collection | DOAJ |
| description | Background: Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample. Methods: National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates. Results: The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients. Conclusions: This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population. |
| format | Article |
| id | doaj-art-11e828682b1b4fb6b141ddf4bae3864d |
| institution | OA Journals |
| issn | 2352-3441 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-11e828682b1b4fb6b141ddf4bae3864d2025-08-20T01:58:33ZengElsevierArthroplasty Today2352-34412024-12-013010151210.1016/j.artd.2024.101512Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison StudyChristian DeMaio, BS0Conner Patrick, MD1Grayson Domingue, MD2Jake Fox, MD3Justin Dvorak, PhD4Rishi Thakral, MD5University of Oklahoma College of Medicine, Oklahoma City, OK, USA; Corresponding author. Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, 800 Stanton L Young Blvd, Andrews Academic Tower 3400, Oklahoma City, OK 73104, USA. Tel.: +1 405 271 4426.Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, klahoma City, OK, USADepartment of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, klahoma City, OK, USADepartment of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USAUniversity of Oklahoma College of Public Health, Oklahoma City, OK, USADepartment of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center, klahoma City, OK, USABackground: Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample. Methods: National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates. Results: The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients. Conclusions: This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population.http://www.sciencedirect.com/science/article/pii/S2352344124001973Hip arthroplastyOsteoarthritisSickle cell diseasePerioperative morbidityOutcomes |
| spellingShingle | Christian DeMaio, BS Conner Patrick, MD Grayson Domingue, MD Jake Fox, MD Justin Dvorak, PhD Rishi Thakral, MD Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study Arthroplasty Today Hip arthroplasty Osteoarthritis Sickle cell disease Perioperative morbidity Outcomes |
| title | Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study |
| title_full | Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study |
| title_fullStr | Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study |
| title_full_unstemmed | Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study |
| title_short | Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study |
| title_sort | total hip arthroplasty complications in patients with sickle cell disease a comparison study |
| topic | Hip arthroplasty Osteoarthritis Sickle cell disease Perioperative morbidity Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124001973 |
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