Long-term safety of total knee arthroplasty in patients with chronic kidney disease in Taiwan: A retrospective cohort study.

Autor: Lin CR; Department of Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333423, Taiwan, ROC., Lee CC; Data Science Center, College of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 242062, Taiwan., Kuo YF; Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Road, Taishan District, New Taipei City 24352, Taiwan., Huang SP; Department of Medical Education & Bioethics, Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, No. 1, Section 1, Ren'ai Road, Zhongzheng District, Taipei City 100233, Taiwan., Chen YC; Data Science Center, College of Medicine, Fu-Jen Catholic University - Master Program of Big Data in Biomedicine, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 242062, Taiwan., Chang SH; Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Road, Taishan District, New Taipei City 24352, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan. Electronic address: a00414@mail.fjuh.fju.edu.tw.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2024 Nov; Vol. 110 (7), pp. 103847. Date of Electronic Publication: 2024 Feb 27.
DOI: 10.1016/j.otsr.2024.103847
Abstrakt: Background: Chronic kidney disease (CKD) is a prevalent condition in Taiwan, and the incidence of total knee arthroplasty (TKA) is on the rise. This study aimed to evaluate the postoperative results of patients with different degrees of CKD after TKA, using data from the Taiwan National Health Insurance Research Database.
Methods: The study analyzed 3078 patients who received TKA from 2012 to 2017, equally divided into three groups: none-CKD, mild CKD (without dialysis), and severe CKD (with dialysis). Propensity score matching was used to minimize selection bias.
Results: After TKA, there was no significant difference in the risk of debridement surgery for infection between the three groups (adjusted HR of mild CKD: 0.71 95% CI=0.36-1.38, p=0.3073; adjusted HR of severe CKD: 1.14, 95% CI=0.63-2.06, p=0.6616). However, CKD patients requiring dialysis had a significantly higher risk of mortality (adjusted HR: 1.98, 95% CI=1.57-2.50, p<0.001) and readmission within 90days of any causes (adjusted HR: 1.83, 95% CI=1.48-2.26, p<0.001) than non-CKD and mild CKD patients.
Conclusion: Severe CKD patients needing dialysis after TKA have a higher risk of mortality and readmission rates than that of the non-CKD or mild CKD patients. If the patient is in the early stage of CKD, their prognosis after receiving TKA is expected to be as good as non-CKD patients.
Level of Evidence: IV; well-designed cohort study.
(Copyright © 2024. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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