PMID- 27660932
OWN - NLM
STAT- MEDLINE
DCOM- 20170531
LR  - 20170531
IS  - 1536-7355 (Electronic)
IS  - 1076-1608 (Linking)
VI  - 22
IP  - 7
DP  - 2016 Oct
TI  - Systemic Lupus Erythematosus Does Not Increase Risk of Adverse Events in the 
      First 6 Months After Total Knee Arthroplasty.
PG  - 355-9
LID - 10.1097/RHU.0000000000000435 [doi]
AB  - BACKGROUND: Increasing numbers of patients with systemic lupus erythematosus 
      (SLE) are undergoing total knee arthroplasty (TKA). Whether postsurgical adverse 
      events (AEs) are higher in patients with SLE than patients with osteoarthritis 
      (OA) is unknown. OBJECTIVES: This study aims to compare AEs within 6 months of 
      TKA. METHODS: Patients in a single institution's arthroplasty and SLE registries 
      who underwent TKA from 2007 to 2014 were eligible. SLE cases were matched 1:2 to 
      OA on age, sex, year of TKA, and procedure type. AEs were collected through chart 
      review and registry responses. Baseline characteristics were compared and 
      regression analysis performed to determine predictors of AEs. RESULTS: Fifty-two 
      SLE TKA were matched to 104 OA TKA. There was no difference in follow-up between 
      groups. SLE patients had more comorbidities (>/=1 Charlson-Deyo comorbidity: SLE 
      38.4% vs. OA 17.3%; P-value < 0.001) and steroid use (preoperative [SLE 28.8% vs. 
      OA 1.9%, P-value < 0.001] and perioperative "stress-dose" [30.8% vs. 2.9%, 
      P-value = 0.01]). SLE patients did not experience more major (SLE 25.0% vs. OA 
      19.2%; P-value = 0.41), minor (15.4% vs. 10.6%; P-value = 0.39), or total (38.5% 
      vs. 27.9%; P-value = 0.18) AEs. AEs were not increased among patients on 
      stress-dose steroids. In a multiple logistic regression analysis controlling for 
      comorbidities and diagnosis, neither SLE (OR 1.61, 95% CI 0.74-3.50) nor >1 
      comorbidity (OR 1.05, 95% CI 0.46-2.39) was an independent risk factor for AEs. 
      CONCLUSION: SLE is not an independent risk factor for increased AEs 6 months 
      after TKA. Stress-dose steroid use does not heighten AE risk. These findings 
      should inform recommendations for SLE patients considering TKA.
FAU - Fein, Arielle W
AU  - Fein AW
AD  - From the *Hospital for Special Surgery, New York, NY; daggerColumbia University 
      College of Physicians and Surgeons, New York, NY; double daggerCase Western Reserve 
      University School of Medicine, Cleveland, OH;  section signSt. George's University School of 
      Medicine, New York, NY;  parallelUniversity of Illinois at Chicago College of Medicine, 
      Chicago, IL;  paragraph signWeill Cornell Medical College, New York, NY; and #Weill Cornell 
      Graduate School of Medical Sciences, New York, NY.
FAU - Figgie, Caroline A
AU  - Figgie CA
FAU - Dodds, Taylor R
AU  - Dodds TR
FAU - Wright-Chisem, Joshua
AU  - Wright-Chisem J
FAU - Parks, Michael L
AU  - Parks ML
FAU - Mandl, Lisa A
AU  - Mandl LA
FAU - Su, Edwin P
AU  - Su EP
FAU - Salmon, Jane E
AU  - Salmon JE
FAU - Mayman, David J
AU  - Mayman DJ
FAU - Lee, Yuo-Yu
AU  - Lee YY
FAU - Figgie, Mark P
AU  - Figgie MP
FAU - Goodman, Susan M
AU  - Goodman SM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Rheumatol
JT  - Journal of clinical rheumatology : practical reports on rheumatic & 
      musculoskeletal diseases
JID - 9518034
SB  - IM
MH  - *Arthroplasty, Replacement, Knee
MH  - Case-Control Studies
MH  - Female
MH  - Humans
MH  - Lupus Erythematosus, Systemic/*complications
MH  - Male
MH  - Middle Aged
MH  - New York/epidemiology
MH  - Osteoarthritis, Knee/*surgery
MH  - Postoperative Complications/*epidemiology
MH  - Risk Factors
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2016/09/24 06:00
MHDA- 2017/06/01 06:00
CRDT- 2016/09/24 06:00
PHST- 2016/09/24 06:00 [entrez]
PHST- 2016/09/24 06:00 [pubmed]
PHST- 2017/06/01 06:00 [medline]
AID - 00124743-201610000-00002 [pii]
AID - 10.1097/RHU.0000000000000435 [doi]
PST - ppublish
SO  - J Clin Rheumatol. 2016 Oct;22(7):355-9. doi: 10.1097/RHU.0000000000000435.