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Risk factors for ileus after hip and knee arthroplasty

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Abstract

Purpose

Postoperative ileus (POI) is one of the complications that can occur after every surgical procedure including arthroplasty. It can have detrimental consequences for the patient and portrays an economic burden on health care systems. The risk factors for POI after arthroplasty described in the literature are scarce and include hip arthroplasty, male gender and previous abdominal surgery. The purpose of the study was to determine the risk factors for POI after hip and knee arthroplasty.

Methods

A retrospective review of 2760 patients undergoing primary hip and knee arthroplasty was performed. An in-depth analysis of patient history and physical operative and postoperative course was reviewed and statistically analyzed in a univariate and multivariate setting.

Results

Overall incidence of POI was 0.54%. History of myocardial infarction and chronic kidney disease were statistically significant risk factors for developing POI after arthroplasty with values of p = 0.023 and p = 0.004, respectively. Other risk factors included previous abdominal surgery (p < 0.001) and hip arthroplasty (p = 0.026). Age or gender correlations were not observed.

Conclusions

Although postoperative ileus is an uncommon complication after joint arthroplasty, in addition to the known risk factors of male age, hip arthroplasty, and previous abdominal surgery, this study describes two previously unknown risk factors: chronic kidney disease and history of myocardial infarction. Patients with these risk factors should be monitored closely for developing postoperative ileus.

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Acknowledgments

We would like to thank Thomas Leonhard, Albert Benzing, and Harald Lintl for their help with the study.

Author information

Authors and Affiliations

  1. Department for Orthopedics, Schwarzwald Baar Klinikum, 78166, Donaueschingen, Germany

    Antonio Klasan

  2. Center for Orthopedics and Traumatology, University Hospital Marburg, 35043, Marburg, Germany

    Antonio Klasan & Philipp Dworschak

  3. Department of Abdominal Surgery, Clinical Hospital Dubrava, 10000, Zagreb, Croatia

    Fedor Amic

  4. Department for Thoracic Surgery, Clinic for Lung Diseases, University Hospital Zagreb, 10000, Zagreb, Croatia

    Goran Madzarac

  5. Orthomedic Frankfurt Offenbach, 63065, Offenbach, Germany

    Thomas Jan Heyse

  6. Department of Orthopaedic Surgery, University Hospital St Etienne, 42270, Saint-Priest-en-Jarez, France

    Thomas Neri

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  1. Antonio Klasan
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Contributions

AK conceived the study and did the data collection. AK, FA, and GM drafted the manuscript. AK and TN performed the statistical analysis. PD revised the manuscript. TH and TN supervised the study and did the final revision of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Antonio Klasan.

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The authors declare that they have no conflict of interest.

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Klasan, A., Amic, F., Dworschak, P. et al. Risk factors for ileus after hip and knee arthroplasty. Int J Colorectal Dis 34, 261–267 (2019). https://doi.org/10.1007/s00384-018-3184-6

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  • DOI: https://doi.org/10.1007/s00384-018-3184-6

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