COMPLICATIONS OF TOTAL HIP ARTHROPLASTY IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Michael M. Ward, MD, MPHHip
Background
To compare the risks of complications of primary total hip arthroplasty (THA) between patients with ankylosing spondylitis (AS) and those without AS.
Methods
In this population-based study, we examined U.S. Medicare beneficiaries (< 75 years old) with AS and a comparison group without AS who had primary THA in 1999 – 2013. Complications were based on the 2013 Centers for Medicare & Medicaid Services THA Complication Measure, which included myocardial infarction, pneumonia, and sepsis within 7 days; surgical site bleeding, pulmonary embolus, or venous thrombosis within 30 days; and mechanical complications or local infection within 90 days. In addition, mortality within 90 days, revision arthroplasty within one year, long length of stay, discharge to a care facility, and readmission within 90 days were examined.
Results
The study included 2773 patients with AS and 107,341 patients without AS who had THA. Perioperative, 30-day complications, and local infections were rare (< 1%) in both groups. Mechanical complications and revision arthroplasty were uncommon in both groups. Ninety-day mortality was lower among patients with AS (0.36% versus 0.7%). Patients with AS were more likely to be discharged to a care facility, and slightly more likely to have a long length of stay. Likelihood of a long stay was lower at hospitals that performed ≥ 100 THA per year, but other complications were not associated with hospital volume.
Conclusions
Complications after primary THA are uncommon in patients with AS and similar in frequency to those without AS. Ninety-day mortality was lower among patients with AS.
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