Primary KneeDoes Metabolic Syndrome Impact the Risk of Reoperation, Revision, or Complication After Primary Total Knee Arthroplasty?
Section snippets
Patient and Methods
After institutional review board approval and utilizing our institutional total joint registry (TJR), 12,269 primary TKAs (9,810 patients) performed for osteoarthritis between January 1, 2008, and December 31, 2017 were identified. All surgeries were performed by high-volume knee arthroplasty surgeons who utilized contemporary cemented implants. Patients who underwent unicompartmental knee arthroplasty, revision TKA, or primary TKAs performed for any indication other than osteoarthritis were
Implant Survivorship
The 5-year implant survivorship free from any reoperation was not different between MetS and non-MetS patients (92.7 and 92.6%, respectively; hazard ratio (HR) = 1, P = .7), any revision (96.9 versus 97.8%, respectively; HR 1.3, P = .2), or reoperation for PJI (98.1 versus 98.7%, respectively; HR 1.4, P = .2) (See Fig. 1). When stratifying the MetS cohort according to BMI (See Table 2), patients with MetS and BMI >40 compared to non-MetS had significantly decreased 5-year implant survivorship
Discussion
MetS is an increasingly prevalent condition encountered in patients undergoing total joint arthroplasty with a reportedly increased risk of perioperative complications [[10], [11], [12], [13], [14],16,[18], [19], [20]]. This study investigated the potential impact of MetS on longer-term outcomes after primary TKA. Although no significant differences were seen in implant survivorship free of reoperations or complications compared to the matching cohort, MetS patients who had a BMI >40 did have a
Acknowledgments
The authors would like to acknowledge the Andrew A. and Mary S. Sugg Professorship in Orthopedic Research for its philanthropic support that made such research possible.
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Investigation performed at the Mayo Clinic, Rochester, MN and Mayo Clinic, Jacksonville, FL.
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2022.08.040.