The association between crystallopathy and postoperative complications following total hip and knee arthroplasty: a...

Crystallopathies, including gout and calcium pyrophosphate deposition (CPPD), are prevalent conditions that complicate total joint arthroplasty (TJA). This study aims to evaluate the impact of crystallopathy on postoperative outcomes following total hip and knee arthroplasty, including complication rates, revision risks, and functional recovery.

A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Studies comparing the outcomes in adult patients undergoing total hip or knee arthroplasty between cases with and without crystallopathy were included. A random-effects meta-analysis was performed using R software version 4.4.2. Sensitivity and subgroup analyses were conducted to identify outliers and assess effect sizes based on crystallopathy type and arthroplasty type.

A total of 23 267 319 TJA cases, including 921 787 crystallopathy group cases, were analyzed. The meta-analysis revealed a significantly higher rate of wound complications (OR = 1.41, 95% CI: 1.03-1.91), prosthetic joint infection (PJI) (OR = 1.97, 95% CI: 1.01-3.83), thromboembolic events (OR = 1.19, 95% CI: 1.06-1.33), and non-home discharge rates (OR = 1.20, 95% CI: 1.02-1.40) in the crystallopathy group, all of which lost significance in sensitivity analysis. However, no significant differences were observed in in-hospital mortality, transfusion needs, myocardial infarction (MI), revision surgery, length of stay (LOS), hospital charges, and emergency department (ED) visits.

Patients with crystallopathies might be at an increased risk of wound complications, PJI, thromboembolic events, and non-home discharge. These findings emphasize the importance of preoperative risk assessment and personalized perioperative management for this patient group.