Increased conditional risk of recurring complications with contralateral total hip arthroplasty surgery

Roberts, Heather J.; Tsay, Ellen L.; Grace, Trevor; Vail, Thomas P.; Ward, Derek

doi:10.1302/0301-620x.101b6.bjj-2018-1488.r1

Cited by 7 publications

(8 citation statements)

References 22 publications

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“…A larger proportion of cases (29.0%) in the INR≤0.9 group had contralateral THA than other groups with statistical signi cance. Some other studies showed contralateral surgery increases the risk of recurring complications in both THA and TKA [24,25]. We did not nd this trend in our study.…”

Section: Discussioncontrasting

confidence: 75%

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Peng¹,

Zeng²,

Zeng³

et al. 2020

Preprint

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Background: Verify if the elevated preoperative International Normalized Ratio (INR) can increase transfusion and complication rate in primary total hip arthroplasty.Methods: We retrospectively reviewed the database of adults who underwent primary total hip arthroplasty between 2014 to 2018 by the same surgeon. 552 cases were assigned into 3 groups by preoperative INR class: INR≤0.9, 0.9＜INR＜1.0, and INR≥1.0 eventually. We regarded the transfusion rate as the primary outcome. We also included perioperative blood loss, maximum Hb-drop, postoperative anemia needs medicine, length of stay (LOS), re-operation, the complication rate in 90 days and mortality as the secondary outcomes. Univariable analyses were utilized to compare baselines and outcomes between groups. Binary Logistic Regression was used to adjust differences of baselines among groups.Results: All the cases had an INR＜1.5. Among all the cases, 93(16.8%) had INR≤0.9, 268 (48.6%) had 0.9＜INR＜1.0, and 191 (34.6%) had INR≥1.0, respectively. In the univariable analyses, with the INR elevated, The transfusion rates increased from 1.08% for INR≤0.9, 1.12% for 0.9＜INR＜1.0 to 5.76% for INR≥1.0 (p＜0.05). The overall complication rate increased from 10.8% for INR≤0.9, 16.4% for 0.9＜INR＜1.0 to 22.5% for INR≥1.0 (p＜0.05). When controlling for the demographics and comorbidities characteristics, there was no statistically significant difference when evaluating the odds of transfusion nor overall complication rate between the groups (p＞0.05).Conclusions: The transfusion and complication rate cannot increase along with the INR elevated in primary THA. With the improvement of arthroplasty protocol and use of tranexamic acid, the INR＜1.5 was still a conventional safe threshold.

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Section: Discussioncontrasting

confidence: 75%

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Peng¹,

Zeng²,

Zeng³

et al. 2020

Preprint

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“…Even though the origin of these complications is not completely clear, they can be due to exacerbated immune responses of the body against foreign body material 16 . Problems with long term safety and reversibility of adverse events due to foreign body material also occur in plastic surgery (breast implants), 11 cardiology (pacemakers), 12 and orthopedics (hip implants) 13 . When looking at the genetic predisposition leading to immune‐mediated, adverse reactions, and genes within the major histocompatibility complex (MHC) have been shown to be associated with auto‐immune diseases as M. Bechterew 17 .…”

Section: Introductionmentioning

confidence: 99%

“…16 Problems with long term safety and reversibility of adverse events due to foreign body material also occur in plastic surgery (breast implants), 11 cardiology (pacemakers), 12 and orthopedics (hip implants). 13 When looking at the genetic predisposition leading to immune-mediated, adverse reactions, and genes within the major histocompatibility complex (MHC) have been shown to be associated with auto-immune diseases as M. Bechterew. 17 And there is also speculation about the HLA subtype-B*08 and HLA subtype-DRB1*03 in immune mediated disorders in women with silicone breast implants.…”

mentioning

confidence: 99%

Increased risk of late‐onset, immune‐mediated, adverse reactions related to dermal fillers in patients bearing HLA‐B 08 and DRB1 03 haplotypes

Decates

Velthuis

Schelke

et al. 2020

Dermatologic Therapy

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Even though manufacturers claim that the dermal fillers are nontoxic and nonimmunogenic, adverse events may occur. Clinically and histologically, most of the late onset adverse events present as an inflammatory response. To assess whether HLA polymorphisms are associated with late‐onset inflammatory adverse events related to dermal fillers. A total of 211 patients were included, of whom 129 experienced late‐onset inflammatory adverse events to different fillers (Inflammation group) and 82 who did not (Reference group). Patients completed a standardized questionnaire and provided a blood sample or oral swap for HLA testing. The study population consisted of 188 (89%) women and 23 (11%) men. The two study groups were similar in the distributions of filler type, location of injecting, allergy, autoimmune disease, gender, age, ethnicity, and smoking status. Of the 211 patients in the sample, 25 had the combination of HLA subtype‐B*08 and HLA subtype‐DRB1*03. This was 16.3% of the inflammatory group and 4.9% of the reference group. This combination of HLA subtypes was associated with an almost 4‐fold increase in the odds of developing immune mediated adverse events (odds ratio = 3.79, 95% CI 1.25‐11.48). Genetic polymorphisms such as HLA combinations may identify patients at risk of developing late onset immune mediated adverse events to dermal fillers.

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“…4–7 This has been reported with other foreign materials 8,9 such as breast implants, 10 pacemakers, 11 and prosthetic joints. 12…”

mentioning

confidence: 99%

Bacterial Contamination Is Involved in the Etiology of Soft-Tissue Filler, Late-Onset, Inflammatory Adverse Events

Decates

Budding²,

Velthuis

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: The treatment algorithm in late-onset inflammatory adverse events with soft-tissue fillers depends primarily on the assumed causative factor: immunologic or bacterial. Methods: The authors included 29 patients, 13 of whom experienced late-onset inflammatory adverse events to fillers (inflammatory group) and 16 who did not (reference group). Biopsies were acquired from both groups with an 18-G needle. Before taking the biopsy, the authors acquired skin swabs for 25 of the 29 patients. The IS-pro method—a new and very sensitive method to detect microbiota—was used. This is a novel broad-range polymerase chain reaction technique based on length and sequence variations of the 16S to 23S ribosomal interspacer region. IS-pro can detect bacteria at low abundances and identify them up to species level. To exclude contamination from skin microbiota, the authors compared the microbiota found on skin swabs with that found in the corresponding biopsies. Results: A high level of Gram-positive bacteria was found in biopsies of soft-tissue fillers, predominantly in patients from the inflammation group. This suggests that these bacteria were introduced during the primary filler injection treatment. The composition of the microbiota on the skin differed markedly from that in the filler, indicating that contamination during the sampling process did not influence results. Conclusions: Bacteria adherent to soft-tissue fillers or bacteremia probably play a causative role in adverse events. Contamination of samples in the biopsies with skin microbiota was excluded. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Increased conditional risk of recurring complications with contralateral total hip arthroplasty surgery

Cited by 7 publications

References 22 publications

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Increased risk of late‐onset, immune‐mediated, adverse reactions related to dermal fillers in patients bearing HLA‐B 08 and DRB1 03 haplotypes

Bacterial Contamination Is Involved in the Etiology of Soft-Tissue Filler, Late-Onset, Inflammatory Adverse Events

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Increased conditional risk of recurring complications with contralateral total hip arthroplasty surgery

Cited by 7 publications

References 22 publications

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

Increased risk of late‐onset, immune‐mediated, adverse reactions related to dermal fillers in patients bearing HLA‐B *08 and DRB1 *03 haplotypes

Bacterial Contamination Is Involved in the Etiology of Soft-Tissue Filler, Late-Onset, Inflammatory Adverse Events

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Product

Resources

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Increased risk of late‐onset, immune‐mediated, adverse reactions related to dermal fillers in patients bearing HLA‐B 08 and DRB1 03 haplotypes