AAOS: Same-Day Double Knee Replacement Safe With RA
RA patients have slightly longer length of stay, but same rates of complications, transfer to rehab
MONDAY, March 17, 2014 (HealthDay News) -- Same-day bilateral total knee arthroplasty (BTKA) is safe in rheumatoid arthritis (RA) patients, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 11 to 15 in New Orleans.
Lazaros A. Poultsides, M.D., from the Hospital for Special Surgery in New York City, and colleagues compared institutional data from 240 RA and 3,680 OA patients undergoing same-day BTKAs from 1998 to 2011.
The authors acknowledge that there were some significant differences between the cohorts, with RA patients being significantly younger and having a significantly higher overall comorbidity burden (both P < 0.001). A significantly higher percentage of RA patients were also female (P < 0.001). In the RA cohort, the mean length of stay (LOS) was higher (5.8 versus 5.4 days; P = 0.007). The two groups did not significantly differ in 30-day mortality rate (P = 0.798); however, the RA group was more likely to have acute postoperative anemia (P < 0.0001) and blood transfusions (P = 0.008). The rates of transfer to a higher level of care (intensive care unit and rehabilitation; P = 0.2) were similar. Additionally, the overall rates of procedure-related (P = 0.644), minor (P = 0.327), and major complications (P = 0.463) were similar between both groups.
"In this retrospective study performed in a high-volume institution, and in which same-day BTKA patients were generally much healthier and younger, we found that same-day BTKA appeared to be safe in the RA patient population," Poultsides and colleagues conclude.