Inflammatory bowel disease is associated with an increased risk of adverse events in patients undergoing joint arthroplasty: a meta-analysis of observational studies

Bone & Joint Research

article

Dongdong Xu¹  Cheng Ding¹  Tao Cheng¹  Chao Yang¹  Xianlong Zhang¹ 

[1] Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

关键词: Joint arthroplasty;    Orthopaedic surgery;    Crohn’s disease;    Ulcerative colitis;    Inflammatory bowel disease;    Postoperative complication;    Cost of care;    inflammatory bowel diseases;    joint arthroplasty;    postoperative infections;    postoperative complications;    revision surgery;    venous thromboembolism (VTE);    surgical complications;    medical complications;    Orthopaedic surgeons;    orthopaedic surgery;   

DOI  :  10.1302/2046-3758.126.BJR-2022-0394.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThe present study aimed to investigate whether patients with inflammatory bowel disease (IBD) undergoing joint arthroplasty have a higher incidence of adverse outcomes than those without IBD.MethodsA comprehensive literature search was conducted to identify eligible studies reporting postoperative outcomes in IBD patients undergoing joint arthroplasty. The primary outcomes included postoperative complications, while the secondary outcomes included unplanned readmission, length of stay (LOS), joint reoperation/implant revision, and cost of care. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model when heterogeneity was substantial.ResultsEight retrospective studies involving 29,738 patients with IBD were included. Compared with non-IBD controls, patients with IBD were significantly more likely to have overall complications (OR 2.11 (95% CI 1.67 to 2.66), p < 0.001), medical complications (OR 2.15 (95% CI 1.73 to 2.68), p < 0.001), surgical complications (OR 1.43 (95% CI 1.21 to 1.70), p < 0.001), and 90-day readmissions (OR 1.42 (95% CI 1.23 to 1.65), p < 0.001). The presence of IBD was positively associated with the development of venous thromboembolism (OR 1.60 (95% CI 1.30 to 1.97), p < 0.001) and postoperative infection (OR 1.95 (95% CI 1.51 to 2.51), p < 0.001). In addition, patients with IBD tended to experience longer LOS and higher costs of care.ConclusionThe findings suggest that IBD is associated with an increased risk of postoperative complications and readmission after joint arthroplasty, resulting in longer hospital stay and greater financial burden. Surgeons should inform their patients of the possibility of adverse outcomes prior to surgery and make appropriate risk adjustments to minimize potential complications.

【 授权许可】

CC BY-NC