Outcomes Following Total Joint Arthroplasty in 1,826 Patients Who Have Skeletal Dysplasia: A Propensity-Matched Cohort Study.

Abstract

Patients who have skeletal dysplasia often require total joint arthroplasty (TJA) due to early joint degeneration; however, anatomic variance and bone deformities present major challenges when considering implant selection and soft tissue balancing. The purpose of this study was to investigate the outcomes of patients who have skeletal dysplasia undergoing total knee and hip arthroplasty. A collaborative network analytics platform was queried to identify patients who had skeletal dysplasia who underwent total hip arthroplasty or total knee arthroplasty. The two cohorts were generated based on the presence of skeletal dysplasia and were 1:1 propensity-matched based on demographic and clinical variables. The incidence of short- and long-term medical and surgical complications was then compared between the two groups. A total of 520,476 patients who had TJA were identified, of which 1,891 had skeletal dysplasia. After 1:1 propensity score matching, each cohort included 1,826 patients, with no significant differences in baseline characteristics (P > 0.05). Across both total knee and hip arthroplasty, the overall incidence of serious medical complications was low at all time points (P > 0.05). However, skeletal dysplasia patients had a significantly higher risk of deep vein thrombosis at 90 days and 1 year (P < 0.05). Regarding surgical complications, patients who had skeletal dysplasia experienced higher rates of periprosthetic fractures at 5 years, as well as revision total hip arthroplasty at 1 year (P < 0.05). There were no significant differences observed between cohorts in the rates of aseptic loosening, periprosthetic joint infection, or prosthetic hip dislocation (P > 0.05). Skeletal dysplasia patients undergoing total joint arthroplasty are at a higher risk of certain medical and orthopaedic complications compared to patients who do not have skeletal dysplasia. These elevated risks did not translate to higher rates of the majority of orthopaedic complications. With appropriate management, TJA can be a durable and effective treatment option in this patient population. Level III, Prognostic Study.