It is unclear how epilepsy may affect total joint arthroplasty outcomes. The purpose of this study is to analyze the impact of epilepsy on prosthesis-related complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). A retrospective cohort study was conducted using a national database. Patients who have epilepsy underwent a primary THA (n = 6,981) and TKA (n = 4,987) and were matched 1:4 (THA, n = 27,924; TKA, n = 19,948). Rates of low-energy falls and prosthesis-related complications within 2 years postoperatively were compared for patients who did and did not have epilepsy with multivariable logistic regression. After primary TKA, patients who have epilepsy exhibited significantly higher rates of aseptic revision (4.3% versus 3.5%, odds ratio [OR] 1.21, = .017) and revision for prosthetic joint infection (1.8% versus 1.3%, OR 1.29, = .041). THA patients who have epilepsy exhibited significantly higher rates of prosthetic dislocation (3.2% versus 1.9%, OR 1.54, < .001), periprosthetic fracture (2.2% versus 0.8%, OR 2.39, < .001), and aseptic loosening (1.7% versus 1.1%, OR 1.40, = .002). Rates of low-energy falls within 2 years after TKA (14.1% versus 6.4%, OR 2.19, < .001) and THA (33.6% versus 7.5%, OR 5.95, < .001) were also significantly higher for patients who have epilepsy. Epilepsy was associated with significantly higher rates of falls ( < .001) and prosthesis-related complications after primary THA ( < .05) and TKA ( < .05). Precautions should be implemented in this population during intraoperative and perioperative decision-making to reduce complication risk. Level III.

中文翻译：

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癫痫对全关节置换术后并发症发生率的影响：倾向评分匹配队列研究

目前尚不清楚癫痫如何影响全关节置换术的结果。本研究的目的是分析癫痫对初次全髋关节置换术（THA）和全膝关节置换术（TKA）后假体相关并发症的影响。使用国家数据库进行了一项回顾性队列研究。癫痫患者接受了初次 THA (n = 6,981) 和 TKA (n = 4,987)，并按 1:4 匹配（THA，n = 27,924；TKA，n = 19,948）。通过多变量逻辑回归比较患有和未患有癫痫的患者术后 2 年内低能量跌倒和假体相关并发症的发生率。初次 TKA 后，癫痫患者表现出显着较高的无菌翻修率（4.3% 对比 3.5%，比值比 [OR] 1.21，= 0.017）和假体关节感染翻修率（1.8% 对比 1.3%，OR 1.29，= .041）。患有癫痫的 THA 患者假体脱位（3.2% 与 1.9%，OR 1.54，< .001）、假体周围骨折（2.2% 与 0.8%，OR 2.39，< .001）和无菌性松动（1.7%）的发生率显着较高对比 1.1%，OR 1.40，= .002)。对于癫痫患者，TKA 术后 2 年内低能量跌倒发生率（14.1% 对比 6.4%，OR 2.19，< .001）和 THA（33.6% 对比 7.5%，OR 5.95，< .001）也显着较高。癫痫与初次 THA (<.05) 和 TKA (<.05) 术后跌倒 (<.001) 和假体相关并发症的发生率显着升高相关。在术中和围手术期决策期间应对该人群采取预防措施，以降低并发症风险。三级。