TKA heightens infection risk in patients with chronic renal disease

Patients in a joint replacement registry who had chronic renal disease and underwent total knee arthroplasty were more likely to have complications with the surgery in this study.
“CRD [chronic renal disease] patients undergoing TKA [total knee arthroplasty] have more comorbidities and a higher risk for superficial SSI [surgical site infections], 90-day re-admission, and any-time mortality,” Alexander Miric, MD, and colleagues wrote.
Miric and colleagues performed a retrospective analysis of data contained in a U.S. l total joint replacement registry that covered seven regions of the country included patients who underwent primary TKA from 2005 to 2010. Of the 41,852 TKAs in the register, 6.4% (2,686) involved patients with CRD. The patients’ mean age was 67 years. Two-thirds of the patients were women. The median follow-up was 2.1 years.
The investigators found CRD patients were older, had poorer general health and a higher prevalence of comorbidities than patients without CRD. Compared to patients without CRD, patients with CRD also had a higher incidence of SSI at 0.9% vs. 0.7%), of superficial SSI at 0.5% vs. 0.3%, of deep vein thrombosis at 0.6% vs. 0.4%, of any-time mortality at 4.7% vs. 2.4%, of 90-day mortality at 0.4% vs. 0.2%, and of 90-day re-admission at 10% vs. 6.0%.
“This procedure can be performed relatively safely in this patient population, with early revision rates, morbidity rates, and mortality rates far below those previously reported,” Miric and colleagues wrote. “However, one cannot ignore that [CRD] patients do present with a wide variety of medical problems and require close attention both during and well beyond the perioperative period,” they noted. – by Christian Ingram

Disclosure: The authors have no relevant financial disclosures

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Miric A. Acta Orthop. 2014;doi: 10.3109/17453674.2013.878829.