title: Perioperative Complications in Patients With Inflammatory Arthropathy Undergoing Total Hip Arthroplasty.
abstract: Limited information exists comparing the short-term complications of the different inflammatory arthropathies (IAs) after total hip arthroplasty (THA). Our objectives were to (1) compare perioperative complications and (2) determine the most common complications between the different IA subtypes compared with patients with osteoarthritis (OA) undergoing primary THA.
  
  
  
  The Nationwide Inpatient Sample was used to identify 2,102,238 patients undergoing elective, unilateral THA between 2002 and 2011. Of these, 86,671 (4%) had an IA, including rheumatoid arthritis (RA), psoriatic arthritis, juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS), and systemic lupus erythematosus (SLE). Preoperative diagnosis, comorbidities, and postoperative complications were determined using International Classification of Disease Clinical Modification version 9 codes. The prevalence of in-hospital medical and orthopedic complications was compared between patients with an IA and OA.
  
  
  
  When compared with patients with OA, patients with RA, JIA, SLE, and AS had significantly more inpatient medical and orthopedic complications immediately after THA (P < .01). Patients with JIA had the highest orthopedic complication rate (2.8%). Specific orthopedic complications by subtype included wound dehiscence for RA and AS periprosthetic fractures for JIA and increased mortality for SLE patients. There were no significant differences in medical or orthopedic complications seen in patients with psoriatic arthritis.
  
  
  
  Differences exist in postoperative inpatient medical and orthopedic complications among patients with different types of IAs after THA. Our results point out the importance of preoperative optimization in patients with IA and monitoring for selective postoperative complications.
authors.affiliation: Desert Orthopedic Center, Eisenhower Medical Center, Rancho Mirage, California.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Schnaser
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
authors.forename: James A
authors.initials: JA
authors.lastname: Browne
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Padgett
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Figgie
authors.affiliation: Center for Advanced Orthopedics, South Miami, Florida.
authors.forename: Michele R
authors.initials: MR
authors.lastname: D'Apuzzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications* / Q000601:surgery; D001171:Arthritis, Juvenile / Q000150:complications / Q000601:surgery; D015535:Arthritis, Psoriatic / Q000150:complications / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007223:Infant; D007297:Inpatients; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011184:Postoperative Period; D015995:Prevalence; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000601:surgery; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: complications; inflammatory arthritis; perioperative; rheumatoid arthritis; total hip arthroplasty