Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis

Background: Previous studies have shown that COVID-19 diagnosis increases rates of perioperative infection, readmission, and other complications following surgery. However, the effect of the COVID vaccine in such patients is unknown. We hypothesized that of the patients with COVID diagnosis, vaccina...

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Main Authors: Pramod Kamalapathy, MD, Corinne Vennitti, MD, Pradip Ramamurti, MD, James A. Browne, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000603
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author Pramod Kamalapathy, MD
Corinne Vennitti, MD
Pradip Ramamurti, MD
James A. Browne, MD
author_facet Pramod Kamalapathy, MD
Corinne Vennitti, MD
Pradip Ramamurti, MD
James A. Browne, MD
author_sort Pramod Kamalapathy, MD
collection DOAJ
description Background: Previous studies have shown that COVID-19 diagnosis increases rates of perioperative infection, readmission, and other complications following surgery. However, the effect of the COVID vaccine in such patients is unknown. We hypothesized that of the patients with COVID diagnosis, vaccinated patients with COVID-19 diagnosis would have lower rates of adverse complications compared to unvaccinated patients undergoing total joint arthroplasty (TJA). Methods: Using a national database registry, patients aged less than 85 years undergoing elective primary total knee or total hip arthroplasty with at least 90 days of follow-up were included during the first year of COVID-19 pandemic from April 2020-April 2021. Patients were included in the COVID-19 cohort if they had a diagnosis on the day of surgery or within 30 days prior to surgery. Patients with a history of malignancy, joint injection, femoral neck fractures, tibial fractures, and those undergoing revision arthroplasty were excluded from the study. All comparisons were performed using multivariate logistic regression with significance set at P < .05. Odds ratio and 95% confidence interval were reported for all comparisons. Results: There were a total of 1280 patients with COVID-19 diagnosis matched with 3831 patients without COVID-19 diagnosis. Patients with a COVID-19 diagnosis were at an increased risk of pneumonia, acute kidney injury, urinary tract infection, and readmission following TJA compared to patients without COVID-19 diagnosis. However, there were no differences in any complications assessed between vaccinated patients and unvaccinated patients with COVID-19 diagnosis following TJA. Conclusions: This study confirms that patients with a COVID-19 diagnosis in the 30 days prior to TJA, whether vaccinated or not, have increased risks of medical complications and hospital utilization. However, this study demonstrates that vaccination status does not appear to be associated with the incidence of adverse postoperative events in patients with a COVID-19 diagnosis prior to TJA.
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spelling doaj-art-6753043d0b134af08eba3dbf54c300b22025-08-20T03:24:08ZengElsevierArthroplasty Today2352-34412025-06-013310167310.1016/j.artd.2025.101673Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 DiagnosisPramod Kamalapathy, MD0Corinne Vennitti, MD1Pradip Ramamurti, MD2James A. Browne, MD3University of Virginia, Department of Orthopaedic Surgery, Charlottesville, VAUniversity of Virginia, Department of Orthopaedic Surgery, Charlottesville, VAUniversity of Virginia, Department of Orthopaedic Surgery, Charlottesville, VACorresponding author. Alfred R. Shands Professor in the Adult Reconstruction, Division of Orthopaedic Surgery, 2280 Ivy Rd, Charlottesville, VA 22903. Tel.: +1 434 924 2663.; University of Virginia, Department of Orthopaedic Surgery, Charlottesville, VABackground: Previous studies have shown that COVID-19 diagnosis increases rates of perioperative infection, readmission, and other complications following surgery. However, the effect of the COVID vaccine in such patients is unknown. We hypothesized that of the patients with COVID diagnosis, vaccinated patients with COVID-19 diagnosis would have lower rates of adverse complications compared to unvaccinated patients undergoing total joint arthroplasty (TJA). Methods: Using a national database registry, patients aged less than 85 years undergoing elective primary total knee or total hip arthroplasty with at least 90 days of follow-up were included during the first year of COVID-19 pandemic from April 2020-April 2021. Patients were included in the COVID-19 cohort if they had a diagnosis on the day of surgery or within 30 days prior to surgery. Patients with a history of malignancy, joint injection, femoral neck fractures, tibial fractures, and those undergoing revision arthroplasty were excluded from the study. All comparisons were performed using multivariate logistic regression with significance set at P < .05. Odds ratio and 95% confidence interval were reported for all comparisons. Results: There were a total of 1280 patients with COVID-19 diagnosis matched with 3831 patients without COVID-19 diagnosis. Patients with a COVID-19 diagnosis were at an increased risk of pneumonia, acute kidney injury, urinary tract infection, and readmission following TJA compared to patients without COVID-19 diagnosis. However, there were no differences in any complications assessed between vaccinated patients and unvaccinated patients with COVID-19 diagnosis following TJA. Conclusions: This study confirms that patients with a COVID-19 diagnosis in the 30 days prior to TJA, whether vaccinated or not, have increased risks of medical complications and hospital utilization. However, this study demonstrates that vaccination status does not appear to be associated with the incidence of adverse postoperative events in patients with a COVID-19 diagnosis prior to TJA.http://www.sciencedirect.com/science/article/pii/S2352344125000603COVID vaccinationCOVID-19TKATHAPrimary total joint arthroplasty
spellingShingle Pramod Kamalapathy, MD
Corinne Vennitti, MD
Pradip Ramamurti, MD
James A. Browne, MD
Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
Arthroplasty Today
COVID vaccination
COVID-19
TKA
THA
Primary total joint arthroplasty
title Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
title_full Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
title_fullStr Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
title_full_unstemmed Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
title_short Vaccination Status is Not Associated With Adverse Postoperative Outcomes Following Total Joint Arthroplasty in Patients With a Preoperative COVID-19 Diagnosis
title_sort vaccination status is not associated with adverse postoperative outcomes following total joint arthroplasty in patients with a preoperative covid 19 diagnosis
topic COVID vaccination
COVID-19
TKA
THA
Primary total joint arthroplasty
url http://www.sciencedirect.com/science/article/pii/S2352344125000603
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