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The impact of Behcet syndrome on total knee arthroplasty outcomes: a retrospective matched cohort study

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Abstract

Purpose

Articu lar involvement is a common manifestation of Behcet syndrome (BS), which can eventually result in significant arthralgia and necessitate total knee arthroplasty (TKA). However, outcomes of BS patients after TKA are still poorly documented in the literature. The purpose of this study was to evaluate BS as a potential risk factor for complications after TKA.

Methods

BS patients undergoing primary TKA were identified from the PearlDiver Mariner database from 2010 to 2021 and compared to 10:1 matched controls. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to two years. Ninety-day emergency department (ED) visit and inpatient readmission were also documented.

Results

A total of 4286 patients undergoing primary TKA were queried, of which 390 had BS. Patients with BS demonstrated significantly higher rates of medical complications, including deep venous thrombosis. The rates of surgical complications were similar between the two groups with the exception of periprosthetic instability, aseptic loosening, and wound complications in BS patients. Additionally, a significantly higher rate of ED visits but markedly lower rates of 90-day readmissions were noted in patients with BS.

Conclusion

Patients with BS undergoing TKA are at higher risks of medical and surgical complications. Special considerations for a unique postoperative course with the higher complications should be made. It is crucial for orthopedic surgeons and patients alike to consider these risks when determining the expected course after TKA for patients with BS.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, 22908, USA

    Zhichang Zhang, Elizabeth Driskill, Jialun Chi, Ian Duensing & Quanjun Cui

  2. Department of Orthopaedic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China

    Zhichang Zhang

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Zhichang Zhang, Elizabeth Driskill, Jialun Chi, Ian Duensing, and Quanjun Cui. The first draft of the manuscript was written by Zhichang Zhang and Elizabeth Driskill, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Quanjun Cui.

Ethics declarations

Ethics approval and consent to participate

This retrospective research study utilized the PearlDiver Patient Records Database, a national private payer insurance database that contains indexed and de-identified data. The database consists of procedural volumes and patient demographics for patients with International Classification of Diseases, 9th Revision diagnoses (ICD-9), 10th Revision diagnoses (ICD-10), and procedures or Current Procedural Terminology (CPT) codes. Our Institutional Review Board deemed this study exempt, including the need for participants’ consent to participate and publish the results.

Competing interests

The authors, Zhichang Zhang, Elizabeth Driskill, and Jialun Chi, declare they have no financial interests. Author Ian Duensing has been involved in 2 multicenter prospective randomized trials investigating periprosthetic joint infection of the hip and knee through which funding was received from Osteal Therapeutics and Trellis Bioscience. Author Quanjun Cui has received research support from Depuy and Exactech, royalty from Elsevier. He is a board member of the Association Research Circulation Osseous (ARCO).

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Zhang, Z., Driskill, E., Chi, J. et al. The impact of Behcet syndrome on total knee arthroplasty outcomes: a retrospective matched cohort study. International Orthopaedics (SICOT) 47, 1989–1994 (2023). https://doi.org/10.1007/s00264-023-05850-6

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  • DOI: https://doi.org/10.1007/s00264-023-05850-6

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