Background: Many systematic reviews have focused on assessing the effect of body mass index (BMI) on the outcomes and complications associated with total hip arthroplasty (THA) and total knee arthroplasty (TKA), but primarily dealt with obesity compared to normal weight (NW). None of these reviews attempted to assess the effect of low BMI or underweight (UW) compared to NW in patients undergoing THA or TKA.
Aim: This review aims to compare specific operative outcomes such as operation duration, length of hospital stay, and post-operative complications including mortality, infections, deep vein thrombosis, along with re-hospitalization and reoperation rates between UW and NW patients undergoing THA, TKA or both.
Methods: An electronic search was performed in PubMed, Scopus, Excerpta Medica database (EMBASE), Web of Science (WoS), and Cochrane Central Register of Controlled Trials (CENTRAL) along with a manual search. The quality of the studies was assessed using the Newcastle-Ottawa scale for cohort studies. The data were subjected to both qualitative and quantitative analysis.
Results: Thirteen retrospective and five prospective cohort studies were included. The quality of included studies was assessed to be good to fair. The length of hospital stay after TKA or THA was found to be significantly higher for UW patients when compared to NW patients, with a mean difference: 0.39 95%CI: [0.06, 0.72], = 0.02 (in days). Studies presenting both THA and TKA together as total joint arthroplasty showed an increased incidence of mortality in patients treated with THA or TKA alone, Odds ratio: 4.18 95%CI: [2.88, 6.07]. A higher incidence of post-operative complications was also observed in UW patients undergoing THA.
Conclusion: UW patients undergoing THA or TKA had a higher incidence of post-operative complications and were associated with a higher readmission rate. Moreover, UW patients were associated with an increased incidence of mortality in the studies that reported THA and TKA together.
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http://dx.doi.org/10.12998/wjcc.v10.i30.10967 | DOI Listing |
Arthroplasty
January 2025
Department of Orthopaedics, Faculty of Medicine, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanulok, Phitsanulok, 65000, Thailand.
Background: Cryotherapy is a non-pharmacological option that complements drug therapy to achieve the most comprehensive multimodal analgesia. Various techniques are currently available, including the conventional gel cold pack, the cryo-cuff, and a novel mobile cold compression device (MCCD). This study aimed to evaluate and compare three cryotherapy techniques in terms of efficacy and patient satisfaction in patients undergoing total knee arthroplasty (TKA).
View Article and Find Full Text PDFAntibiotics (Basel)
December 2024
Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04317 Leipzig, Germany.
: The objective of this study was to compare infection rates, pathogen species detection and antimicrobial susceptibility testing in patients with total hip arthroplasty (THA) and total knee arthroplasty (TKA) following post-traumatic osteoarthritis (PTOA) and primary osteoarthritis (POA). : Patients undergoing both THA and TKA were significantly more likely to have a PJI after PTOA than after POA (THA: 2.5% vs.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612.
Background: Ambulatory Surgery Centers (ASCs) have been shown to deliver high-quality care to patients at major cost savings to the healthcare system. The objective of this investigation was to examine trends in the Medicare facility and surgeon professional fee payments for hip and knee arthroplasty.
Methods: Publicly available Medicare data was analyzed to determine professional and facility fee payments for unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and total hip arthroplasty (THA) to ASCs and hospitals between 2018 and 2024.
BMC Musculoskelet Disord
December 2024
Department of Surgery, Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, University of Eastern Finland, Kuopio, Finland.
Background: The optimal length of thromboprophylaxis after total hip or knee arthroplasty (THA and TKA) is unknown. Fast-track protocols have improved patient care and led to shorter immobilization and length of stay (LOS) after THA and TKA, thereby diminishing venous thromboembolism (VTE) risk. Here, we investigated risk stratification-based thromboprophylaxis after fast-track THA and TKA.
View Article and Find Full Text PDFSurgeon
December 2024
Program on Behavioral Economics and Public Policy, Harvard Law School, Cambridge, MA, USA; Robert Walmsley University Professor, Harvard University, Cambridge, MA, USA.
Background: The framing effect has been demonstrated in a variety of settings. This study aimed to determine whether framing of complication risk in total hip arthroplasty (THA) and long-term patient satisfaction rates in total knee arthroplasty (TKA) influences patient decision-making and 'worry' using hypothetical vignettes.
Methods: Two cross-sectional survey studies were undertaken, one based on a THA vignette and one based on a TKA vignette.
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