Surgical outcomes of hip and knee arthroplasties for primary osteoarthritis in patients with Alzheimer's disease: a nationwide registry-based case-controlled study.
We compared the length of hospitalisation, rate of infection, dislocation of the hip and revision, and mortality following primary hip and knee arthroplasty for osteoarthritis in patients with Alzheimer's disease (n = 1064) and a matched control group (n = 3192). The data were collected from nationwide Finnish health registers. Patients with Alzheimer's disease had a longer peri-operative hospitalisation (median 13 days vs eight days, p < 0.001) and an increased risk for hip revision with a hazard ratio (HR) of 1.76 (95% confidence interval (CI) 1.03 to 3.00). Dislocation was the leading indication for revision. There was no difference in the rates of infection, dislocation of the hip, knee revision and short-term mortality. In long-term follow-up, patients with Alzheimer's disease had a higher mortality (HR 1.43; 95% CI 1.22 to 1.70), and only one third survived ten years post-operatively. Increased age and comorbidity were associated with longer peri-operative hospitalisation in patients with Alzheimer's disease.
Coxa, Hospital for Joint Replacement, P.O. Box 652, FIN-33101, Tampere, Finland.
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E
Jämsen
National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland.
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M
Peltola
Coxa, Hospital for Joint Replacement, P.O. Box 652, FIN-33101, Tampere, Finland.
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T
Puolakka
Coxa, Hospital for Joint Replacement, P.O. Box 652, FIN-33101, Tampere, Finland.
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A
Eskelinen
University of Tampere, FIN-33014 Tampere, Finland.
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MU
Lehto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D005260:Female; D005387:Finland; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications* / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D016896:Treatment Outcome; D055815:Young Adult
Alzheimer's disease; dementia; hip replacement; knee replacement