COVID-19 diagnosis prior to TJA may increase complication risk
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.
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.
“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.
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Lung B, et al. Paper 188. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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