Total Knee Arthroplasty in Patients with Spinal Cord Injury: Impact on Medical Complications, Hospital Costs and Length of Stay.

J Am Acad Orthop Surg Glob Res Rev

From the University of Texas Southwestern, Dallas, TX (Dr. Sambandam); Dallas VAMC, Dallas, TX (Dr. Sambandam and Dr. Mounasamy); University of New Mexico School of Medicine, Albuquerque, NM (Dr. Cheppalli); VAMC, Albuquerque, NM (Dr. Cheppalli); Salem VA Medical Center, Salem, VA (Dr. Menedal); Carroll High School, Southlake, TX (Senthil); School of Medicine, University of Texas Medical Branch, Galveston, TX (Sakthivelnathan); and the Department of Orthopedics, University of Texas Southwestern, Dallas, TX (Dr. Mounasamy).

Published: April 2023

Introduction: Patients with spinal cord injury (SCI) with degenerative joint disease of the knee may require total knee arthroplasty (TKA). This study examines the demographic and immediate postoperative outcomes of patients with SCI who undergo TKA.

Methods: Admissions data for TKA and SCI were analyzed from the National Inpatient Sample database using International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes. An extensive array of preoperative and postoperative variables was compared among SCI TKA patients and non-SCI TKA patients. An unmatched and matched analysis using a 1:1 propensity match algorithm was conducted to compare the two groups.

Results: Patients with SCI tend to be younger and have a 7.518 times greater risk of acute renal failure, 2.3 times greater risk of blood loss, and higher risk of local complications, including periprosthetic fracture and prosthetic infection. The average length of stay in the SCI cohort was 2.12 times greater, with a 1.58 times higher mean total incurred charge than the non-SCI group.

Conclusion: SCI is associated with an increased risk of acute renal failure, blood loss anemia, periprosthetic fractures and infections, a longer length of stay, and greater incurred charges in TKA patients.

Study Design: Retrospective study.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082245PMC
http://dx.doi.org/10.5435/JAAOSGlobal-D-22-00145DOI Listing

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