Patel Akshar V, Stevens Andrew, Shahzad Hania, Iyer Amogh I, Ragland Dashaun, Cvetanovich Gregory, Bishop Julie Y, Rauck Ryan C
Department of Orthopaedics, The Ohio State University College of Medicine, Columbus, OH, USA.
Shoulder Elbow. 2024 Oct;16(5):527-533. doi: 10.1177/17585732231194615. Epub 2023 Aug 10.
The objective of this study is to investigate the effect of allergies on complications following total shoulder arthroplasty (TSA).
All data were collected by using the PearlDiver national database to identify patients who had undergone TSA (anatomic or reverse) between 1 January 2010 and 31 October 2021. Patients were stratified into two groups: allergies and no allergies. Comparisons were made regarding complications and revision surgeries. Complications were compared at 30 and 90 days. Revisions were compared at 1, 5 and 10 years postoperatively.
This study identified 28,182 patients with allergies and 126,296 patients without allergies. Patients with allergies were more likely to require revision surgery at all time points analyzed (p < 0.001). Patients with allergies were more likely to have sepsis within 30 (OR 1.53 [1.30-1.80], p < 0.001) and 90 days (1.71 [1.51-1.94], p < 0.001) postoperatively. Patients with allergies were more likely to experience a wound complication within 30 (1.89 [1.58-2.26], p < 0.001) and 90 days (1.81 [1.58-2.08], p < 0.001). The allergy group experienced higher rates of prosthetic joint infections (PJI) (2.14 [1.81-2.54], p < 0.001) and implant complications at 90 days (1.52 [1.42-1.62], p < 0.001).
Patients with allergies were more likely to require revision surgery, experience wound complications, sepsis and PJI following TSA.
本研究的目的是调查过敏对全肩关节置换术（TSA）后并发症的影响。
通过使用PearlDiver国家数据库收集所有数据，以识别2010年1月1日至2021年10月31日期间接受TSA（解剖型或反置型）的患者。患者被分为两组：过敏组和非过敏组。对并发症和翻修手术进行比较。在术后30天和90天比较并发症情况。在术后1年、5年和10年比较翻修情况。
本研究确定了28182例过敏患者和126296例非过敏患者。在所有分析的时间点，过敏患者更有可能需要进行翻修手术（p<0.001）。过敏患者在术后30天（比值比1.53[1.30-1.80]，p<0.001）和90天（1.71[1.51-1.94]，p<0.001）更有可能发生败血症。过敏患者在术后30天（1.89[1.58-2.26]，p<0.001）和90天（1.81[1.58-2.08]，p<0.001）更有可能出现伤口并发症。过敏组在90天时人工关节感染（PJI）发生率更高（2.14[1.81-2.54]，p<0.001），植入物并发症发生率更高（1.52[1.42-1.62]，p<0.001）。
过敏患者在TSA后更有可能需要进行翻修手术，出现伤口并发症、败血症和PJI。
