Survivorship and Outcomes in Patients With Multiple Sclerosis Undergoing Total Joint Arthroplasty.
Publication/Presentation Date
4-1-2018
Abstract
BACKGROUND: Patients with multiple sclerosis (MS) frequently require total joint arthroplasty (TJA). The outcomes of TJA in patients with MS, who are frequently on immunomodulatory medications and physically deconditioned, remain largely unknown. The aim of this study is to elucidate the survivorship and reasons for failure in this patient population.
METHODS: A single-institution retrospective review of 108 TJAs (46 knees and 62 hips) was performed from 2000 to 2016. An electronic chart query based on MS medications and International Classification of Diseases, Ninth Revision codes was used to identify this population followed by a manual review to confirm the diagnosis. Outcomes were then assessed using revision for any reason as the primary end point. Functional outcomes were assessed using Short Form 12 scores. Survivorship curves were generated using the Kaplan-Meier method.
RESULTS: At an average follow-up of 6.2 years, 19.4% (21/108) of patients required a revision surgery. Instability (5.6%, P = .0278) and periprosthetic joint infection (4.6%, P = .0757) were among the most common reasons for revision. The overall survivorship of TJA at years 2, 5, and 7, respectively, was 96.5% (95% confidence interval [CI], 92.6-100), 86.3% (95% CI, 77.7-94.5), and 75.3% (95% CI, 63.5-87.0). Functional score improvement was less in MS cohort than patients without MS.
CONCLUSION: Patients with MS are at increased risk of complications, particularly instability and periprosthetic joint infection. Despite this increased risk of complications, patients with MS can demonstrate improved functional outcomes, but not as much as patients without MS. Patients with MS should be counseled appropriately before undergoing TJA.
Volume
33
Issue
4
First Page
1024
Last Page
1027
ISSN
1532-8406
Published In/Presented At
Rondon, A. J., Schlitt, P. K., Tan, T. L., Phillips, J. L., Greenky, M. R., & Purtill, J. J. (2018). Survivorship and Outcomes in Patients With Multiple Sclerosis Undergoing Total Joint Arthroplasty. The Journal of arthroplasty, 33(4), 1024–1027. https://doi.org/10.1016/j.arth.2017.10.056
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
29174408
Department(s)
Administration and Leadership
Document Type
Article