Patients With Uncontrolled Components of Metabolic Syndrome Have Increased Risk of Complications Following Total Joint Arthroplasty
Section snippets
Methods and Materials
Following approval from the institutional review board, the joint arthroplasty database at this institution was utilized to identify those patients undergoing TJA with MetS between April 2000 and December 2007. Several authors have proposed varying definitions of this syndrome [14]. For the purpose of this study, we defined MetS as a body mass index (BMI) greater than 30 kg/m2, as well as a history of dyslipidemia, hypertension, and diabetes.
Control of MetS was assessed by preoperative blood
Results
During the period of time queried, we identified 133 patients who had all four components of MetS. These patients underwent 148 TJAs (103 primary knee, 34 primary hip, 7 revision knee, and 4 revision hip) during 136 admissions. Patients had an average age of 65 years (range: 40–86 years), average BMI of 37 kg/m2 (range: 30–70 kg/m2), and 79 (59%; 79/133) were female.
Within this group, 36 (26.5%; 36/136) patients had at least a single uncontrolled component of MetS. There were seven cases with
Discussion
Total joint arthroplasty is a successful procedure that provides significant relief and return to function for a majority of patients. Nevertheless, severe complications do occur and can require costly work-up and treatments including possible reoperations. Many of these complications–which can include PE, stroke, infection, acute renal failure, and cardiovascular events among many others–have devastating effects on the patient's outcome and general health. Over the past decades, many efforts
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Cited by (49)
Does Metabolic Syndrome Impact the Risk of Reoperation, Revision, or Complication After Primary Total Knee Arthroplasty?
2023, Journal of ArthroplastyCitation Excerpt :Those with MetS and BMI >40 demonstrated the significantly lowest mean KSS (74 versus 78 for non-MetS, P = .04) and KSFS (59 versus 75, P < .001) at 5 years. MetS is an increasingly prevalent condition encountered in patients undergoing total joint arthroplasty with a reportedly increased risk of perioperative complications [10–14,16,18–20]. This study investigated the potential impact of MetS on longer-term outcomes after primary TKA.
Decreasing Trend in Complications for Patients With Obesity and Metabolic Syndrome Undergoing Total Knee Arthroplasty From 2006 to 2017
2022, Journal of ArthroplastyCitation Excerpt :While the decreasing trend in 30-day complications in these patients is promising, we found that MetS–related comorbidities such as hypertension and diabetes increased the odds of 30-day major and minor complications in obese patients, and hypertension also increased the odds of 30-day major complications in nonobese patients. Previous studies have shown that uncontrolled components of MetS may be associated with an increased risk of complications following both TKA and THA, and recent meta-analyses suggest that MetS may be associated with the risk of developing severe OA [12–14]. As such, our results emphasize the importance of recognizing and mitigating these risk factors.
The Impact of Metabolic Syndrome on Reoperations and Complications After Primary Total Hip Arthroplasty
2022, Journal of Arthroplasty“Uncontrolled” Hypertension Is Not an Independent Risk Factor for Adverse Short-Term Outcomes Following Total Joint Arthroplasty
2022, Journal of ArthroplastyCitation Excerpt :Although the necessity of blood pressure optimization prior to TJA remains unchallenged [7,18,19], the implication of this finding is that the current standards for what is considered uncontrolled HTN may be inappropriate and overly simplistic for use among the arthroplasty population. The standards in current practice are based upon findings involving nonsurgical patients in the general population examining long-term outcomes as well as surgical patients undergoing a variety of procedures [13,15,20,21,24–26]. The questionable applicability of long-term adverse outcomes in a general population of patients to surgical arthroplasty patients is obvious.
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2012.12.018.