title: Greater Wound and Renal Complications in Gout Patients Undergoing Total Joint Arthroplasty.
abstract: Little is known about total joint arthroplasty (TJA) outcomes in gout patients. The purpose of this study was to compare adverse events between gout and nongout patients who underwent primary TJA.
  
  
  
  Using our institutional database and medical records review, a retrospective case-control study was conducted. From 2000 to 2012, a total of 482 gout TJA patients were matched with nongout TJA patients in a 1:1 ratio. Length of stay, complications, 90-day emergency room visits, and 90-day readmissions in these patients were compared.
  
  
  
  Gout patients had greater wound healing problems (12.2% vs 5.0%, P = .001) and renal complications (8.9% vs 3.1%, P = .0003) compared with nongout patients. There were no significant differences between gout and nongout patients in terms of mean length of hospital stay (3.82 vs 3.17 days, P = .11) and 90-day emergency room visits (5.6% vs 3.5%, P = 1.00). Subgroup analysis showed that 90-day readmission rates were higher in gout patients who underwent total hip arthroplasty compared with those in nongout THA patients (6.8% vs 2.1%, P = .02).
  
  
  
  Gout patients undergoing TJA have greater wound healing problems and renal complications. Surgeons should be cognizant of fluid management, renal monitoring and wound issues and should be cautious when treating TJA gout patients.
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chi-Lung
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Hongyi
authors.initials: H
authors.lastname: Shao
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Block
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Antonia F
authors.initials: AF
authors.lastname: Chen
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015992:Body Mass Index; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006073:Gout / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000191:economics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D014945:Wound Healing
keywords: complication; gout; total hip arthroplasty; total joint arthroplasty; total knee arthroplasty