Holzapfel, Dominik Emanuel and Meyer, Matthias and Thieme, Max and Pagano, Stefano and von Kunow, Frederik and Weber, Markus (2023) Delay of total joint replacement is associated with a higher 90-day revision rate and increased postoperative complications. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 143. pp. 3957-3964. ISSN 0936-8051, 1434-3916
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Purpose Delay of elective surgeries, such as total joint replacement (TJR), is a common procedure in the current pandemic. In trauma surgery, postponement is associated with increased complication rates. This study aimed to evaluate the impact of postponement on surgical revision rates and postoperative complications after elective TJR. Methods In a retrospective analysis of 10,140 consecutive patients undergoing primary total hip replacement (THR) or total knee replacement (TKR) between 2011 and 2020, the effect of surgical delay on 90-day surgical revision rate, as well as internal and surgical complication rates, was investigated in a university high-volume arthroplasty center using the institute's joint registry and data of the hospital administration. Moreover, multivariate logistic regression models were used to adjust for confounding variables. Results Two thousand four hundred and eighty TJRs patients were identified with a mean delay of 13.5 +/- 29.6 days. Postponed TJR revealed a higher 90-day revision rate (7.1-4.5%, p < 0.001), surgical complications (3.2-1.9%, p < 0.001), internal complications (1.8-1.2% p < 0.041) and transfusion rate (2.6-1.8%, p < 0.023) than on-time TJR. Logistic regression analysis confirmed delay of TJRs as independent risk factor for 90-day revision rate [OR 1.42; 95% CI (1.18-1.72); p < 0.001] and surgical complication rates [OR 1.51; 95% CI (1.14-2.00); p = 0.04]. Conclusion Alike trauma surgery, delay in elective primary TJR correlates with higher revision and complication rates. Therefore, scheduling should be performed under consideration of the current COVID-19 pandemic.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FEMORAL-NECK FRACTURES; HIP FRACTURE; SURGICAL DELAY; KNEE ARTHROPLASTY; OPERATIVE DELAY; MORTALITY; SURGERY; MORBIDITY; IMPACT; RISK; Surgical delay; Surgery postponement; Elective surgery; TJR; THA; TKA; Postoperative complications; Revision rate; COVID-19 pandemic |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 07 Nov 2024 08:52 |
| Last Modified: | 07 Nov 2024 08:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57465 |
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