Serological risk factors associated with arthroplasty complications

Post-operative complications can have a devastating impact on patients' quality of life. Peri-operative bloodwork is often routinely conducted and may predict post-operative complications. The purpose of this study is to understand if pre- or post-operative serology is associated with post-operative complications arising from hip and knee arthroplasty.

A retrospective chart review of 383 participants with post-operative total hip and knee arthroplasty complications was conducted. One hundred and forty-one participants with post-operative complications were included and compared to a control group of 120 participants. Patient, surgical, and pre- and post-operative serological data were collected. L2-regularized logistic regression was utilized to assess whether identified factors independently predicted post-operative complications.

The complications group had higher age, male sex, presence of osteoporosis, Charlson Comorbidity Index and bilateral arthroplasties compared to the control group (p < 0.05). Pre-operatively, the complications group had a lower hemoglobin value (p = 0.027; OR = 0.64) and higher Basophil Count (p = 0.012, OR = 2.23) and Monocyte-Lymphocyte ratio (p = 0.003, OR = 2.23), higher rates of undergoing a general anesthetic (p = 0.019, OR = 0.43) and psychiatric illness (p = 0.001, OR = 3.07). Post-operatively, the complications group had lower WBC (p = 0.040, OR = 0.55) and Neutrophil counts (p = 0.001, OR = 0.45), increased Eosinophil count (p = 0.018, OR = 2.36), increased age (p = 0.034, OR = 2.06) and BMI (p = 0.049, OR = 1.74), having postoperative anticoagulation other than ASA (p = 0.000, OR = 3.99).

We identified multiple peri-operative patient, surgical, and serological risk factors for developing post-operative complications following hip and knee arthroplasty. These markers could be prioritized for monitoring high-risk patients for possible intervention.