Do breast cancer patients have increased risk of complications after primary total hip and total knee arthroplasty?

Autor:	Ledford CK; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida, USA., Shirley MB; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Spangehl MJ; Department of Orthopedic Surgery, Mayo Clinic, Scottsdale, Arizona, USA., Berry DJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Abdel MP; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	The bone & joint journal [Bone Joint J] 2024 Apr 01; Vol. 106-B (4), pp. 365-371. Date of Electronic Publication: 2024 Apr 01.
DOI:	10.1302/0301-620X.106B4.BJJ-2023-0968.R1
Abstrakt:	Aims: Breast cancer survivors have known risk factors that might influence the results of total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study evaluated clinical outcomes of patients with breast cancer history after primary THA and TKA. Methods: Our total joint registry identified patients with breast cancer history undergoing primary THA (n = 423) and TKA (n = 540). Patients were matched 1:1 based upon age, sex, BMI, procedure (hip or knee), and surgical year to non-breast cancer controls. Mortality, implant survival, and complications were assessed via Kaplan-Meier methods. Clinical outcomes were evaluated via Harris Hip Scores (HHSs) or Knee Society Scores (KSSs). Mean follow-up was six years (2 to 15). Results: Breast cancer patient survival at five years was 92% (95% confidence interval (CI) 89% to 95%) after THA and 94% (95% CI 92% to 97%) after TKA. Breast and non-breast cancer patients had similar five-year implant survival free of any reoperation or revision after THA (p ≥ 0.412) and TKA (p ≥ 0.271). Breast cancer patients demonstrated significantly lower survival free of any complications after THA (91% vs 96%, respectively; hazard ratio = 2 (95% CI 1.1 to 3.4); p = 0.017). Specifically, the rate of intraoperative fracture was 2.4% vs 1.4%, and venous thromboembolism (VTE) was 1.4% and 0.5% for breast cancer and controls, respectively, after THA. No significant difference was noted in any complications after TKA (p ≥ 0.323). Both breast and non-breast cancer patients experienced similar improvements in HHSs (p = 0.514) and KSSs (p = 0.132). Conclusion: Breast cancer survivors did not have a significantly increased risk of mortality or reoperation after primary THA and TKA. However, there was a two-fold increased risk of complications after THA, including intraoperative fracture and VTE. Competing Interests: 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. D. J. Berry is funded by grants from the National Institutes of Health (R01AR73147, R01HL147155), NIAMS (P30AR76312). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. C. K. Ledford is a committe member of AAHKS, AAOS, and ABOS. M. B. Shirley has no disclosures. M. J. Spangehl reports institutional research support from Stryker and DePuy Synthes, and stock or stock options in Sonoran Biosciences, all of which are unrelated to this study. D. J. Berry reports royalties from DePuy, Elsevier, and Wolters Kluwer Health, consulting fees and research support payments from DePuy, honoraria from AO Recon, and a leadership or fiduciary role in the International Hip Society, Hip Society, Knee Society, and Orthopaedic Research and Education Foundation, all of which are unrelated to this study. M. P. Abdel is on the Board of Directors of IOEN, Mid-America, and the AAHKS, and reports royalties from OsteoRemedies, Springer, and Stryker, all of which are unrelated to this study. (© 2024 The British Editorial Society of Bone & Joint Surgery.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu