TKA Complications Increased for Patients With Sickle Cell Disease

HealthDay News — Patients with sickle cell disease (SCD) undergoing total knee arthroplasty (TKA) have longer length of stay, incur greater health care costs, and have an increased risk for complications during the perioperative period, according to a study recently published in the Archives of Orthopaedic and Trauma Surgery.

Vibhu Krishnan Viswanathan, M.B.B.S., from the University of Calgary in Alberta, Canada, and colleagues examined postoperative complication rates and outcomes of patients undergoing TKA between 2016 and 2019 using data from the National Inpatient Sample database. The cohort was classified into two groups: those with and without SCD (groups A and B, respectively). Data were included for 558,361 patients who underwent unilateral, primary TKA; 0.1 percent were known cases of SCD (group A).

The researchers found that patients in group A had a significantly higher risk for longer duration of perioperative hospital stay, greater health care costs incurred, and increased need for alternative step-down health care facilities after discharge. During the perioperative period, 24.7, 20.9, and 24.9 percent of the SCD patients developed acute chest syndrome, pain crisis, and splenic sequestration crisis, respectively. The incidence rates of acute renal failure, need for blood transfusion, and deep vein thrombosis were significantly higher in the early admission period for group A patients.

“SCD patients undergoing total knee replacement need a multidisciplinary approach and may be better served in specialized centers capable of caring for these complex medical patients,” a coauthor said in a statement.

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