US Renal Data System 2012 Annual Data Report Collins, Allan J., MD; Foley, Robert N., MB; Herzog, Charles, MD ...
American journal of kidney diseases,
01/2013, Letnik:
61, Številka:
1
Journal Article
US Renal Data System 2010 Annual Data Report Collins, Allan J., MD; Foley, Robert N., MB; Herzog, Charles, MD ...
American journal of kidney diseases,
01/2011, Letnik:
57, Številka:
1
Journal Article
US Renal Data System 2013 Annual Data Report Collins, Allan J., MD; Foley, Robert N., MB; Chavers, Blanche, MD ...
American journal of kidney diseases,
01/2014, Letnik:
63, Številka:
1
Journal Article
US Renal Data System 2011 Annual Data Report Collins, Allan J., MD; Foley, Robert N., MB; Chavers, Blanche, MD ...
American journal of kidney diseases,
01/2012, Letnik:
59, Številka:
1
Journal Article
Abstract Background Cervical spondylotic myelopathy (CSM) is a common and underdiagnosed cause of gait dysfunction, rigidity, and falls in the elderly. Given the frequent concurrency of CSM and hip ...osteoarthritis, this study is designed to evaluate the relative risk of CSM on peri-operative and short-term outcomes following total hip arthroplasty (THA). Methods The Medicare Standard Analytical Files were searched from 2005-2012 to identify all patients undergoing primary THA as well as the subset of patients with preexisting CSM. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for 90-day, 1-year, and overall follow-up for common post-operative complications: periprosthetic dislocation, fracture, infection, revision THA, and wound complications. Results The RR of all surgical complications, including dislocation, periprosthetic fractures and prosthetic joint infection, were increased approximately 2-fold at all post-operative time-points for patients. Conclusions Preexisting CSM is a significant risk-factor for primary THA complications including dislocation, periprosthetic fractures and prosthetic joint infection.
Background Ankylosing spondylitis (AS) in a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive ...sagittal balance, and altered biomechanics. The purpose of this study is to determine the complication profile of patients with AS undergoing total hip arthroplasty (THA). Methods The Medicare sample was searched from 2005-2012 yielding 1006 patients with AS that subsequently underwent THA. Risk-ratios (RR) with 95% confidence intervals (CIs) were calculated for 90-day, 2-year and final post-operative follow-up for complications including: hip dislocation, periprosthetic fracture, wound complication, revision THA, and post-operative infection. Results Compared to controls, patients with AS had a RR of 2.50 (CI:1.04-5.99) for 90-day and a RR of 1.99 (CI:1.10-3.59) for 2-year THA component breakage. The RR of periprosthetic hip dislocation was elevated at 90-days (1.44, CI:0.93-2.22) and significantly increased at 2-years (1.67,CI:1.25-2.23) and overall follow-up (1.49,CI:1.14-1.93). Similarly, the RR for THA revision was elevated at 90-days (1.46, CI:0.97-2.18) and significantly increased at 2-years (1.69,CI:1.33-2.14) and overall follow-up (1.51,CI:1.23-1.85). The risk of periprosthetic infection and wound complications was higher in the AS group at all time-points with RRs ranging from 1.46-2.44. Conclusions Patients with AS are at increased risk for complications following THA. Altered biomechanics from a rigid, kyphotic spine place increased demand on the hip joints. The elevated peri- and post-operative risks should be discussed pre-operatively and these patients may require increased pre-operative medical optimization as well as possible changes in component selection and position to compensate for altered spinopelvic biomechanics.
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