Systemic Lupus Erythematosus Does Not Increase Risk of Adverse Events in the First 6 Months After Total Knee Arthroplasty. Issue 7 (October 2016)

• Record Type: Journal Article
• Authors: Fein, Arielle W.; Figgie, Caroline A.; Dodds, Taylor R.; Wright-Chisem, Joshua; Parks, Michael L.; Mandl, Lisa A.; Su, Edwin P.; Salmon, Jane E.; Mayman, David J.; Lee, Yuo-Yu; Figgie, Mark P.; Goodman, Susan M.
• Is Part Of: Journal of clinical rheumatology. Volume 22:Issue 7(2016)
• Publication Date: 2016-10
• Subjects: arthroplasty -- systemic lupus erythematosus -- osteoarthritis -- knee -- adverse events; Rheumatism -- Periodicals; Rheumatology -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Musculoskeletal Diseases -- Periodicals; Rheumatic Diseases -- Periodicals; Rhumatisme -- Périodiques; Rhumatologie -- Périodiques; Appareil locomoteur -- Maladies -- Périodiques; Musculoskeletal system -- Diseases; Rheumatism; Rheumatology; Periodicals; 616.723005
• DOI: 10.1097/RHU.0000000000000435
• Languages: English
• ISSNs: 1076-1608

Abstract

Abstract : Background: Increasing numbers of patients with systemic lupus erythematosus (SLE) are undergoing total knee arthroplasty (TKA). Whether postsurgical adverse events (AEs) are higher in patients with SLE than patients with osteoarthritis (OA) is unknown. Objectives: This study aims to compare AEs within 6 months of TKA. Methods: Patients in a single institution's arthroplasty and SLE registries who underwent TKA from 2007 to 2014 were eligible. SLE cases were matched 1:2 to OA on age, sex, year of TKA, and procedure type. AEs were collected through chart review and registry responses. Baseline characteristics were compared and regression analysis performed to determine predictors of AEs. Results: Fifty-two SLE TKA were matched to 104 OA TKA. There was no difference in follow-up between groups. SLE patients had more comorbidities (≥1 Charlson-Deyo comorbidity: SLE 38.4% vs. OA 17.3%; P -value < 0.001) and steroid use (preoperative [SLE 28.8% vs. OA 1.9%, P -value < 0.001] and perioperative "stress-dose" [30.8% vs. 2.9%, P -value = 0.01]). SLE patients did not experience more major (SLE 25.0% vs. OA 19.2%; P -value = 0.41), minor (15.4% vs. 10.6%; P -value = 0.39), or total (38.5% vs. 27.9%; P -value = 0.18) AEs. AEs were not increased among patients on stress-dose steroids. In a multiple logistic regression analysis controlling for comorbidities and diagnosis, neither SLE (OR 1.61, 95% CI 0.74–3.50) nor >1 comorbidity (OR 1.05, 95% CI 0.46–2.39) was an independent risk factor for AEs. Conclusion: SLE is not an independent risk factor for increased AEs 6 months after TKA. Stress-dose steroid use does not heighten AE risk. These findings should inform recommendations for SLE patients considering TKA.