With the increasing utilization of total knee arthroplasty (TKA) in a continually aging US population, the number of patients who have low bone mineral density who undergo TKA may concomitantly increase. This study aimed to assess the rates of short-term complications following TKA in patients who did and did not have a recent history of a prior fragility fracture. A matched retrospective cohort study analyzing 48,796 patients was performed using a national database to determine the impact of a preceding fragility fracture on rates of short-term complications following TKA. The rates of complications at 1 and 2 years post-TKA were analyzed using multivariate logistic regressions. Prior fragility fracture was associated with increased rates of 1-year hospital readmissions (hazard ratio = 1.30, 95% CI, 1.22-1.38), periprosthetic fractures (odds ratio [OR] = 2.72, 95% CI, 1.89-3.99), non–infection-related revisions (OR = 1.32, 95% CI, 1.09-1.60), secondary fragility fractures (OR = 4.62, 95% CI, 4.19-5.12), prosthesis dislocations (OR = 1.76, 95% CI, 1.22-2.56), prosthesis instabilities (OR = 1.64, 95% CI, 1.25-2.15), and periprosthetic infections (OR = 1.49, 95% CI, 1.29-1.71), with similar trends in implant-related complications also seen at the 2-year mark. Patients who filled a prescription for osteoporosis pharmacotherapy had clinically similar rates of these complications compared to those who did not. Sustaining a fragility fracture prior to TKA is associated with an increased risk of hospital readmission and significant implant-related postoperative complications, potentially increasing the morbidity and mortality of TKA in these patients.

中文翻译：

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最近有脆性骨折病史的患者再入院和植入相关并发症的风险增加：匹配队列分析

随着美国人口不断老龄化，全膝关节置换术（TKA）的使用率不断增加，接受全膝关节置换术的骨密度低的患者数量可能会随之增加。本研究旨在评估近期有或没有脆性骨折病史的患者全膝关节置换术后短期并发症的发生率。使用国家数据库对 48,796 名患者进行了一项匹配的回顾性队列研究，以确定之前的脆性骨折对 TKA 后短期并发症发生率的影响。使用多元逻辑回归分析 TKA 后 1 年和 2 年的并发症发生率。既往脆性骨折与 1 年再入院率增加相关（风险比 = 1.30，95% CI，1.22-1.38）、假体周围骨折（比值比 [OR] = 2.72，95% CI，1.89-3.99）、非– 感染相关翻修（OR = 1.32，95% CI，1.09-1.60）、继发性脆性骨折（OR = 4.62，95% CI，4.19-5.12）、假体脱位（OR = 1.76，95% CI，1.22-2.56） ）、假体不稳定（OR = 1.64，95% CI，1.25-2.15）和假体周围感染（OR = 1.49，95% CI，1.29-1.71），2 年时也观察到与种植体相关的并发症的类似趋势标记。服用骨质疏松症药物治疗处方的患者与未服用药物治疗的患者相比，这些并发症的临床发生率相似。 TKA 前维持脆性骨折会增加再入院的风险以及与种植体相关的术后并发症，可能会增加这些患者 TKA 的发病率和死亡率。