Total Hip Arthroplasty Outcomes: An 18-Year Experience in a Single Center: Is Systemic Lupus Erythematosus a Potential Risk Factor for Adverse Outcomes?

摘要

Abstract Background In patients with systemic lupus erythematosus (SLE), persistent joint activity and treatment with glucocorticoids are associated with musculoskeletal complications. About 30% of these patients become candidates for surgical treatment. The aim of this study was to evaluate postoperative outcomes after total hip arthroplasty (THA) in SLE patients. Methods We performed a retrospective cohort study at a tertiary care center in Mexico City between 1995 and 2013. All patients with SLE who underwent THA during that period were included (n?= 58). They were compared with 2 control groups, one from another inflammatory arthropathy (rheumatoid arthritis, n?= 58) and other noninflammatory (osteoarthritis, n?= 58), matched by gender and date of surgery. The primary outcome was the frequency of postoperative complications during follow-up. Results We included 174 patients who underwent THA during the study period. Patients with SLE were younger ( P P ?= .001), and required more transfusions ( P ?=?.004). Global complications in THA in patients with SLE were more prevalent than rheumatoid arthritis (36.2% vs 15.5%, P ?= .029) and osteoarthritis (36.2% vs 5.1%, P P ?= .018) and low postoperative hemoglobin (hazard ratio 0.77, 95% confidence interval 0.73-0.83; P ? Conclusion This is the largest single-center study regarding clinical outcomes after THA in SLE patients. Our data suggest that SLE is an independent risk factor for adverse postoperative outcomes, mainly immediate complications, but the long-term outcome is good enough to offer surgical treatment that will improve quality of life.