Related Experiment Video
Updated: Jan 11, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
The effects of multiple myeloma on total knee arthroplasty outcomes: A retrospective study
Background:
Total knee arthroplasty (TKA) is a common orthopedic procedure, yet outcomes in patients with multiple myeloma (MM) remain poorly understood since there are limited studies. As a result, the aim was to assess how MM affects outcomes of patients undergoing TKA.
Methods:
In this retrospective cohort study, patients with MM who underwent TKA were identified using a TriNetX national database from 2005 to 2024. These patients were matched to controls without MM using propensity score matching based on age, sex and relevant comorbidities. Postoperative complication rates, readmission, revision surgery, and mortality were analyzed over a one-year follow-up.
Results:
A total of 237, 007 patients who had TKR were matched to 353 patients with MM who had TKR. MM patients were older, male (mean age 70.3 vs 67 years) and had a higher incidence of comorbidities at baseline. MM patients had significantly higher rates of wound dehiscence (1.98 % vs 0.52 %, p = .003), periprosthetic infection (2.27 % vs 0.81 %, p = .009), acute renal failure (5.95 % vs 1.96 %, p < .001), blood loss anemia (15.01 % vs 6.53 %, p < .001),DVT (2.55 % vs 1.27 p = .049), myocardial infarction (0.85 % vs 0.21 %, p = .040), pulmonary embolism (3.12 % vs 0.84 %, p < .001) and pneumonia. However, one-year mortality rates did not differ significantly between groups.
Conclusion:
MM is associated with an increased risk of postoperative complications following TKA compared to control patients but not mortality. This study highlights multispecialty tailored perioperative care protocols for MM patients undergoing TKA to decrease complications.
Insights
Patients with multiple myeloma (MM) undergoing total knee arthroplasty (TKA) face higher risks of surgical complications but not mortality. Tailored perioperative care is crucial for improving outcomes in these patients.
Area of Science:
- Orthopedic Surgery
- Hematology
- Oncology
Background:
- Total knee arthroplasty (TKA) is a common procedure, but outcomes for multiple myeloma (MM) patients are understudied.
- Limited research exists on the impact of MM on TKA success rates and patient recovery.
Purpose of the Study:
- To investigate the effect of multiple myeloma on TKA outcomes.
- To compare postoperative complication rates, readmission, revision surgery, and mortality in MM patients versus controls.
Main Methods:
- Retrospective cohort study using the TriNetX national database (2005-2024).
- Propensity score matching of MM patients with controls based on age, sex, and comorbidities.
- Analysis of one-year postoperative outcomes including complications, readmission, revision, and mortality.
Main Results:
- MM patients (n=353) were older, more often male, and had more comorbidities than controls (n=237,007).
- Significantly higher rates of wound dehiscence, periprosthetic infection, acute renal failure, anemia, DVT, myocardial infarction, pulmonary embolism, and pneumonia in MM patients.
- No significant difference in one-year mortality rates between MM patients and controls.
Conclusions:
- Multiple myeloma is associated with increased postoperative complications after TKA.
- Mortality rates at one year did not significantly differ between MM patients and controls.
- Multispecialty tailored perioperative care protocols are recommended for MM patients undergoing TKA to mitigate complications.
