Patients with SLE had more complications after TJA compared to patients with OA

LAS VEGAS — Compared to patients with osteoarthritis, patients with systemic lupus erythematosus who underwent total joint arthroplasty had more complications after surgery, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Mark P. Figgie, MD, and colleagues studied 58 adult patients with systemic lupus erythematosus (SLE) who were matched by age and gender to 116 patients with osteoarthritis (OA). Patients with SLE met at least three of 11 American College of Rheumatology criteria for SLE and the disease was confirmed by a rheumatologist. Patients with SLE were more likely to have additional comorbidities than patients with OA.

Most of the patients with SLE were prescribed immunosuppressants such as glucocorticoids for treatment compared to 2% of patients with OA under immunosuppressive therapy. At baseline, patients with SLE had higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores than patients with OA.

All patients underwent either total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single center. Multiple logistic regression and univariate analyses showed that patients with SLE were more likely to experience both minor and severe adverse events following surgery and have a longer length of stay at the hospital.

“Despite improvements in disease management, patients with lupus should still be recognized as high risk patients in total hip replacement,” Figgie said, and he added that the use of immunosuppressants may contribute to complications, but no associations with specific drugs were seen in the study analysis. – by Shirley Pulawski

Reference:

Roberts J, et al. Paper #596. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.

Disclosure: Figgie reports no relevant financial disclosures.