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Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty?

Publication ,  Journal Article
Hernandez, NM; Vakharia, RM; Bolognesi, MP; Mont, MA; Seyler, TM; Roche, MW
Published in: J Knee Surg
January 2023

Well-powered studies evaluating the effects of Paget's disease on patient outcomes following primary total knee arthroplasty (TKA) are limited. The objective of this study was to determine whether Paget's disease patients undergoing primary TKA have higher rates of complications. A query of an administrative database was performed identifying Paget's disease patients undergoing primary TKA as the study cohort. Patients who did not have Paget's disease served as a matching cohort. Study group patients were matched in a 1:5 ratio by age, sex, and comorbidities. The query yielded 34,284 patients in the study (n = 5,714) and matched (n = 28,570) cohorts. Outcomes analyzed included length of stay (LOS), costs of care, 90-day medical and surgical complications, and 2-year implant-related complications. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of complications. Paget's disease patients undergoing primary TKA were found to have significantly longer in-hospital LOS (4 vs. 3 days, p < 0.0001). Study group patients incurred significantly higher 90-day episode-of-care costs ($15,124.55 vs. $14,610.01, p < 0.0001). Additionally, Paget's disease patients were found to have higher incidences and odds of medical/surgical (25.93 vs. 13.58%; OR: 1.64, p < 0.0001) and implant-related complications (8.97 vs. 5.02%; OR: 1.71, p < 0.0001). Specifically, Paget's disease patients were more likely to have periprosthetic fractures, mechanical loosening, and revision TKAs (p < 0.0001). This study demonstrated that Paget's disease was associated with longer in-hospital LOS, increased costs, and higher rates of complications. The study can be utilized by physicians to adequately educate patients with Paget's disease concerning potential complications following their primary TKA.

Duke Scholars

Published In

J Knee Surg

DOI

EISSN

1938-2480

Publication Date

January 2023

Volume

36

Issue

1

Start / End Page

1 / 5

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Periprosthetic Fractures
  • Length of Stay
  • Humans
  • Hospitals
  • Arthroplasty, Replacement, Knee
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Hernandez, N. M., Vakharia, R. M., Bolognesi, M. P., Mont, M. A., Seyler, T. M., & Roche, M. W. (2023). Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty? J Knee Surg, 36(1), 1–5. https://doi.org/10.1055/s-0041-1727180
Hernandez, Nicholas M., Rushabh M. Vakharia, Michael P. Bolognesi, Michael A. Mont, Thorsten M. Seyler, and Martin W. Roche. “Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty?J Knee Surg 36, no. 1 (January 2023): 1–5. https://doi.org/10.1055/s-0041-1727180.
Hernandez NM, Vakharia RM, Bolognesi MP, Mont MA, Seyler TM, Roche MW. Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty? J Knee Surg. 2023 Jan;36(1):1–5.
Hernandez, Nicholas M., et al. “Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty?J Knee Surg, vol. 36, no. 1, Jan. 2023, pp. 1–5. Pubmed, doi:10.1055/s-0041-1727180.
Hernandez NM, Vakharia RM, Bolognesi MP, Mont MA, Seyler TM, Roche MW. Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty? J Knee Surg. 2023 Jan;36(1):1–5.
Journal cover image

Published In

J Knee Surg

DOI

EISSN

1938-2480

Publication Date

January 2023

Volume

36

Issue

1

Start / End Page

1 / 5

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Periprosthetic Fractures
  • Length of Stay
  • Humans
  • Hospitals
  • Arthroplasty, Replacement, Knee
  • 3202 Clinical sciences
  • 1103 Clinical Sciences