Prior Harriet, Jamil Zenab, Rodriguez Ariel N, Swiggett Samuel J, Weisberg Miriam D, Razi Afshin E, Choueka Jack
Department of Orthopedic Surgery, Maimonides Medical Center, 927 49th Street, Brooklyn, NY, 11219, USA.
College of Medicine, State University of New York Downstate, Brooklyn, NY, USA.
Eur J Orthop Surg Traumatol. 2023 Oct;33(7):3153-3158. doi: 10.1007/s00590-023-03550-w. Epub 2023 Apr 16.
Aseptic loosening is a feared complication following total elbow arthroplasty (TEA); however, literature regarding factors that may contribute to this complication is limited. The aims of this investigation were to: (1) compare baseline demographics of patients who developed aseptic loosening following primary TEA; and (2) identify patient-specific risk factors for the development of loosening.
Retrospective analysis using a nationwide claims database was performed to identify patients who underwent primary TEA and developed aseptic loosening within 2 years (study n = 307, control n = 10,741). Multivariate regression analysis generated odds ratio (OR), 95% confidence interval (95% CI), and p-value of risk factors. p < 0.05 was considered statistically significant.
Patients who developed aseptic loosening had significant differences in numerous demographics, including age (p = 0.0001), sex (p = 0.0251), and various comorbid conditions such as obesity (15.96% vs. 8.36%, p < 0.0001). Furthermore, the risk factors most associated with aseptic loosening were obesity (OR 1.65, 95% CI 1.18-2.28, p = 0.002), male sex (OR 1.51, 95% CI 1.13-2.00, p = 0.004), and concomitant opioid use disorder (OR 1.58, 95% CI 1.14-2.15, p = 0.004).
This study is the first to identify demographics and patient-related risk factors associated with aseptic loosening following primary TEA. This evidence could be applied to the clinical setting in order to educate at-risk patients of this potential complication as well as inform their post-operative clinical management.
Level III: Prognostic.
无菌性松动是全肘关节置换术（TEA）后令人担忧的并发症；然而，关于可能导致该并发症的因素的文献有限。本研究的目的是：（1）比较初次TEA后发生无菌性松动的患者的基线人口统计学特征；（2）确定发生松动的患者特异性风险因素。
使用全国性索赔数据库进行回顾性分析，以识别接受初次TEA并在2年内发生无菌性松动的患者（研究组n = 307，对照组n = 10,741）。多变量回归分析得出风险因素的比值比（OR）、95%置信区间（95%CI）和p值。p < 0.05被认为具有统计学意义。
发生无菌性松动的患者在众多人口统计学特征方面存在显著差异，包括年龄（p = 0.0001）、性别（p = 0.0251）以及各种合并症，如肥胖（15.96%对8.36%，p < 0.0001）。此外，与无菌性松动最相关的风险因素是肥胖（OR 1.65，95%CI 1.18 - 2.28，p = 0.002）、男性（OR 1.51，95%CI 1.13 - 2.00，p = 0.004）和同时存在阿片类药物使用障碍（OR 1.58，95%CI 1.14 - 2.15，p = 0. 004）。
本研究首次确定了与初次TEA后无菌性松动相关的人口统计学特征和患者相关风险因素。该证据可应用于临床环境，以对有风险的患者进行这种潜在并发症的教育，并为其术后临床管理提供参考。
III级：预后性。
