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February 15, 2024
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COVID-19 diagnosis prior to TJA may increase complication risk

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Key takeaways:

  • Total joint arthroplasty performed within 2 weeks of COVID-19 diagnosis yielded an increased complication risk.
  • Further research is needed on when to undergo total joint arthroplasty after COVID-19 diagnosis.

SAN FRANCISCO — Results presented here showed patients who underwent total hip or knee arthroplasty within 2 weeks of a COVID-19 diagnosis were at an increased risk for venous thromboembolism, sepsis and surgical site infection.

“Establishing a timeframe of when it is best to undergo these operations with minimum postoperative complications after COVID-19 diagnosis needs further research,” Shaelyn Choi, BA, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

COVID variant
Patients who underwent total hip or knee arthroplasty within 2 weeks of a COVID-19 diagnosis were at an increased risk for venous thromboembolism, sepsis and surgical site infection. Image: Adobe Stock

Using the National COVID Cohort Collaborative, a database of 17.5 million people with 6.5 million positive COVID cases, Choi and colleagues categorized 110,186 patients who underwent THA (n=50,158) or TKA (n=65,569) into groups based on whether they were diagnosed with COVID-19 at 0 to 2 weeks, 2 to 6 weeks or 6 to 12 weeks prior to surgery. Researchers compared patients who tested positive for COVID-19 with patients who tested negative for COVID-19 based on age, sex, Charlson Comorbidity Index and BMI.

Shaelyn Choi
Shaelyn Choi

“The postoperative complications that we included were [venous thromboembolism] VTE, sepsis, surgical site infection, 30-day mortality and 1-year all-cause mortality,” Choi said.

Patients with a diagnosis of COVID-19 within 0 to 2 weeks and 2 to 6 weeks of undergoing THA had similar complication profiles, including increased risk for VTE, 30-day mortality and 1-year mortality, according to Choi. She added patients with a diagnosis of COVID-19 within 2 weeks of undergoing TKA had increased risk for sepsis and 30-day mortality.

“Interesting, both the total hip and total knee patients showed an increased 1-year mortality rate for undergoing their surgery 6 to 12 weeks after their COVID diagnosis,” Choi said.