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Post-operative complications of total knee arthroplasty in patients with hypertension

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Abstract

Background

Hypertension is one of the most common comorbidities among patients undergoing surgery. However, few studies have focused on patients undergoing knee arthroplasty, and most of them had small sample sizes. This study aimed to analyze post-operative complications associated with hypertension in patients who underwent knee replacement surgery.

Methods

Data from the 2019 National Inpatient Sample (NIS) database were used. Patients who underwent primary total knee arthroplasty (pTKA) and those who underwent aseptic revision total knee arthroplasty (rTKA) were analyzed separately. Propensity score matching was performed to reduce the effects of demographic factors and comorbidities other than hypertension on post-operative complications. A multinomial logistic regression that included all significantly different demographics and comorbidities was performed to verify the results and evaluate the odds ratios.

Results

A total of 107,981 patients who underwent pTKA and 6571 who underwent rTKA owing to mechanical complications were identified in the 2019 NIS database. Compared with the non-hypertension group, patients with hypertension had a higher risk of developing acute renal failure and electrolyte disorders after TKA. Further analysis revealed that hyponatraemia and hypokalaemia were associated with hypertension.

Conclusions

Hypertension was associated with the incidence of acute renal failure after TKA. It is important to identify patients with risk factors for acute renal failure (in addition to hypertension) and take careful measures to prevent acute renal failure in them.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. 

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Funding

This study was funded by the The National Key R&D Program of China (No.2021YFA1102600), National Natural Science Foundation of China (No. 82002293, 82272443), Guangdong Basic and Applied Basic Research Foundation (Grant No. 2019A1515011647, 2021A1515010693, 2021A1515010294, 2022A1515010256), Science and Technology Planning Project of Guangzhou City, China (Grant No. 202201020495, 202201020481).

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Authors and Affiliations

  1. Department of Orthopaedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, Guangdong, China

    Xiaoyu Li, Hao Sun, Zhencheng Huang, Meiyi Chen, Deng Li, Zhiqing Cai, Jie Xu & Ruofan Ma

  2. Department of Anesthesiology, Yunyang County People’s Hospital, Chongqing, 404500, China

    Hao Li

  3. Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 518033, Guangdong, China

    Zhencheng Huang

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  1. Xiaoyu Li
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  2. Hao Sun
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  9. Ruofan Ma
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Contributions

Xiaoyu Li and Hao Sun contributed equally to this work. Xiaoyu Li and Hao Sun contributed to the conception of the study. Hao Li, Deng Li, and Zhiqing Cai acquired the data. Zhencheng Huang and Meiyi Chen performed data analysis. Xiaoyu Li and Hao Sun contributed significantly to manuscript preparation. Jie Xu and Ruofan Ma revised the work critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jie Xu or Ruofan Ma.

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Ethics approval

This study was ruled exempt from formal review by the Ethical Committee of Sun Yat-sen Memorial Hospital, given the use of deidentified, previously collected data.

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The authors declare no competing interests.

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Cite this article

Li, X., Sun, H., Li, H. et al. Post-operative complications of total knee arthroplasty in patients with hypertension. International Orthopaedics (SICOT) 47, 701–709 (2023). https://doi.org/10.1007/s00264-022-05668-8

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  • DOI: https://doi.org/10.1007/s00264-022-05668-8

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