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Patients With Multiple Sclerosis are at Increased Risk for Postoperative Complications Following Total Hip and Knee

Nicole Durig Quinlan1, Dennis Q Chen1, Brian C Werner1

  • 1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

The Journal of Arthroplasty
|May 11, 2019
PubMed
Abstract

Insights

Multiple sclerosis (MS) patients undergoing hip or knee replacement surgery face higher risks of complications, readmissions, and infections. This indicates MS is a significant risk factor, leading to increased healthcare costs and longer hospital stays.

Area of Science:

  • Orthopedic Surgery
  • Neurology
  • Public Health

Background:

  • Multiple sclerosis (MS) is a chronic central nervous system inflammatory demyelinating disease.
  • Improved therapies are increasing the lifespan of MS patients, leading to a greater need for joint replacement surgeries.
  • Evaluating MS as a risk factor for postoperative complications after arthroplasty is crucial.

Purpose of the Study:

  • To assess the impact of multiple sclerosis on postoperative complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Main Methods:

  • A national insurance database was used to identify patients with MS who underwent THA or TKA between 2005 and 2014.
  • Outcomes analyzed included death, readmission, emergency room visits, infection, revision, dislocation/stiffness, cost, and length of stay.
  • Patients with MS were compared to a 10:1 matched control group without MS.

Main Results:

  • Patients with MS undergoing THA or TKA showed significantly higher rates of hospital readmission, emergency room visits, and infection compared to controls.
  • MS patients undergoing THA had increased rates of revision and dislocation.
  • Diagnosis of MS was linked to significantly higher costs and longer hospital stays for both THA and TKA procedures.

Conclusions:

  • Multiple sclerosis is associated with an elevated risk of postoperative complications after both total hip and total knee arthroplasty.
  • MS diagnosis leads to increased healthcare utilization and costs following arthroplasty procedures.
Keywords:
complicationship arthroplastyknee arthroplastymultiple sclerosisoutcomes

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