Abstract
Background
Few studies investigate the influence of inflammatory bowel disease (IBD) on complications
following total knee arthroplasty (TKA). Therefore, we compared complications and
readmissions frequencies after TKA in patients with Crohn’s disease (CD) and ulcerative
colitis (UC) to patients without IBD.
Methods
A large administrative claims database was used to identify patients who underwent
primary TKAs from 2010 to 2019 and had a diagnosis of IBD before TKA. Patients were
stratified into two groups: those with CD (n = 8,369) and those with UC (n = 11,347).
These patients were compared a control of 1.3 million patients without an IBD diagnosis.
Chi-square and unadjusted odds ratios (OR) with 95% confidence intervals (CI) were
used to compare complication frequencies. Multivariable logistic regression was used
to evaluate independent risk factors for 90-day complications.
Results
Compared to patients without IBD, patients with IBD were associated with higher unadjusted
90-day odds for Clostridium difficile infection (CDI) (CD: OR 2.81 [95% CI 2.17 to
3.63]; p < 0.001; UC: OR 3.01 [95% CI 2.43 to 3.72]; p < 0.001) and two-year periprosthetic joint infection (CD: OR 1.34 [95% CI 1.18 to
1.52]; p < 0.001; UC: OR 1.26 [95% CI 1.13 to 1.41]; p < 0.001). After controlling for risk factors like obesity, tobacco use, and diabetes,
both types of IBD were associated with higher 90-day odds for CDI and PJI (p < 0.001 for all).
Conclusion
IBD is associated with higher 90-day postoperative CDI and PJI compared with patients
without IBD. Providers should consider discussing these risks with patients who have
a diagnosis of IBD.
Keywords
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Article info
Publication history
Published online: December 31, 2022
Accepted:
December 14,
2022
Received in revised form:
October 25,
2022
Received:
May 12,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
