Early acute complications after total knee arthroplasty in patients with rheumatoid arthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: The number of rheumatoid arthritis patients undergoing total knee arthroplasty is increasing, but the postoperative early complications and related risk factors have not been reported. OBJECTIVE: To investigate the early acute complications and the risk factors after primary total knee arthroplasty in patients with rheumatoid arthritis. METHODS: Data of 300 patients (337 knees) with rheumatoid arthritis who received primary total knee arthroplasty at Affiliated Hospital of Qingdao University from September 2013 to May 2019 were retrospectively analyzed. There were 62 males and 238 females, with an age of (65.61±8.40) years old. All patients signed the informed consent, and the study was approved by the ethics committee of the hospital. The baseline data, comorbidities, preoperative examination, surgical data, other data of hospitalization and follow-up data were recorded. The risk factors of complications were analyzed. The receiver operating characteristic curve was used to assess the predictive value of risk factors for postoperative complications within 30 days after surgery in rheumatoid arthritis patients. RESULTS AND CONCLUSION: (1) Nine cases (3.33%) affected acute complications within 30 days after surgery. (2) Multivariate Logistic regression analysis showed that operation time, age, duration of disease and preoperative cerebrovascular disease were independent risk factors for postoperative complications within 30 days after total knee arthroplasty in rheumatoid arthritis patients. (3) Compared with the non-complication group, in the complication group, the operation time was longer (OR=1.023, 95%CI 1.001-1.045, P=0.037), the age was increased (OR=1.163, 95%CI 1.025-1.319, P=0.019), the duration of disease was longer (OR=1.110, 95%CI 1.031-1.195, P=0.006), and the proportion of preoperative cerebrovascular disease was increased (OR=31.736, 95%CI 4.053-248.517, P=0.001). (4) The receiver operating characteristic curve to predict the complications in patients with rheumatoid arthritis within 30 days after total knee arthroplasty showed that the area under the curve of age, duration of disease and operation time were 0.693, 0.865 and 0.685, respectively.