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Medical- and Implant-Related Complications Following Total Joint Arthroplasty in Patients Who Have Chronic

Hugo C Rodriguez1, Kevin L Mekkawy2, Brandon D Rust3

  • 1Larkin Community Hospital, Department of Orthopaedic Surgery, South Miami, Florida; Hospital for Special Surgery, Department of Orthopaedic Surgery, West Palm Beach, Florida.

The Journal of Arthroplasty
|October 10, 2024
PubMed

Insights

Patients with chronic lymphocytic leukemia (CLL) undergoing total joint arthroplasty face significantly higher medical and implant complication risks. Surgeons must consider CLL status for improved patient counseling and outcomes.

Area of Science:

  • Orthopaedic Surgery
  • Hematology
  • Oncology

Background:

  • Chronic lymphocytic leukemia (CLL) is common in patients undergoing total joint arthroplasty (TJA).
  • Previous evaluations of TJA outcomes in CLL patients are limited.
  • This study addresses TJA complications, healthcare utilization, and revision rates in CLL patients.

Purpose of the Study:

  • To assess 90-day medical complications after TJA in CLL patients.
  • To evaluate implant-related complications and revision rates in CLL patients.
  • To analyze healthcare utilization, including length of stay and readmission, for CLL patients undergoing TJA.

Main Methods:

  • Retrospective cohort study identifying CLL patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA).
  • CLL patients were matched 1:5 with non-CLL controls based on demographics and comorbidities.
  • Outcomes included 90-day medical complications, 2-year implant complications, length of stay, 90-day readmission, and time to revision.

Main Results:

  • CLL patients experienced significantly higher odds of 90-day medical complications (e.g., pneumonia, myocardial infarction, acute kidney injury) after TKA and THA.
  • CLL patients had increased risks of implant complications, including periprosthetic fracture, mechanical loosening, and prosthetic joint infection.
  • CLL patients had longer hospital stays, higher 90-day readmission rates, and earlier revision times for THA compared to controls.

Conclusions:

  • CLL status is a significant risk factor for increased medical and implant complications following TJA.
  • Orthopaedic surgeons should incorporate CLL status into preoperative counseling and risk stratification.
  • Proactive management strategies are needed to mitigate complications and optimize outcomes for CLL patients undergoing TJA.
Abstract

Keywords:
chronic lymphocytic leukemiacomplicationsoncologyoutcomestotal joint arthroplasty

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