Patient-reported allergies cause inferior outcomes after total knee arthroplasty

Hinarejos, Pedro; Ferrer, Tulia; Leal, Joan; Torres-Claramunt, Raúl; Sánchez-Soler, Juan; Monllau, Joan Carles

doi:10.1007/s00167-015-3837-8

Cited by 30 publications

(35 citation statements)

References 29 publications

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“…Hilton et al 31 found that increasing medical comorbidities (as determined by the Charlson index) postoperatively correlated with subsequent worsening of physical function and pain outcomes post-TKA. Hinarejos et al 32 found that patients with at least one self-reported allergy had worse postoperative outcomes in terms of the WOMAC and KSS knee scores for TKA than patients without allergies. They proposed that allergies could be considered a prognostic factor and possibly used when counselling TKA patients preoperatively.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…They proposed that allergies could be considered a prognostic factor and possibly used when counselling TKA patients preoperatively. 32 Oberbek et al 33 found that increased body weight and a high BMI, above 35, influenced the level of pain severity in the operated knee joint and physical activity of the patient after the surgery. Their results indicated the need for further evaluation of BMI as a prognostic factor in the planning of physiotherapy in patients treated for idiopathic osteoarthritis of the knee joint after TKA.…”

Section: Comorbiditiesmentioning

confidence: 99%

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Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature

2018

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It is estimated that up to a third of recipients of total knee arthroplasty (TKA) experience chronic pain postoperatively. However, there are no clear indications within the literature that predict which patients are at higher risk of being dissatisfied with their TKA. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is one of the most commonly used, patient-reported outcome measures in patients with lower limb osteoarthritis. This review discusses the available evidence surrounding the predictability of the outcome of TKA using the WOMAC score as well as considering further patient factors that have been implicated in the level of improvement post TKA. It may be concluded from the available literature that a combination of knee scores and patient factors would be the most accurate way of predicting those patients most likely to have a good outcome from their TKA. There is some disparity within the literature about which patient factors and reported outcome measure scores lead to a positive postoperative outcome. Patient expectations following the procedure also need to be evaluated, as objective measures on a scoring system do not necessarily equate with the subjective patient experience.

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Section: Comorbiditiesmentioning

confidence: 99%

Section: Comorbiditiesmentioning

confidence: 99%

Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature

2018

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“…These results suggest that although antibiotic allergy may itself predict a longer length of stay and increased risk of complications (2)(3)(4), it is unlikely to be the dominant explanation for the findings we observed.…”

Section: Disclosures Of Conflicts Ofmentioning

confidence: 59%

“…The inclusion of such patients may have affected the results, as an association has been previously demonstrated between known or suspected penicillin allergy and increased number of hospital inpatient days as well as infection with pathogenic organisms such as Clostridium difficile and methicillinresistant Staphylococcus aureus (3). Another study of patients with a history of antimicrobial allergy similarly demonstrated an association with lengthier hospital stay, higher intensive care unit admission rate, and increased in-hospital mortality rate (4).…”

Section: Editormentioning

confidence: 99%

Allergic Status Is a Confounder for Inpatient Length of Stay and Outcome Analysis

Scheinfeld¹,

Dym²,

Sprayregen³

et al. 2016

Radiology

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“…Various subspecialties, such as hip and knee arthroplasty, have evaluated this and shown that patients with multiple reported allergies have less improvement in patient-reported outcomes postoperatively compared with patients with fewer allergies. 1 - 3 This topic has also been investigated in shoulder arthroplasty; however, the results have been varied. A recent study by Rosenthal et al revealed that the presence of one or more self-reported allergies did not correlate with worse function, satisfaction, pain, or range of motion postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery

Lyons

Borsinger

Lucas

et al. 2019

Global Spine Journal

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Study Design: Retrospective review. Objective: Previous literature demonstrates mixed results regarding the relationship between patient-reported allergies and pain, function, and satisfaction scores. The objective of this study was to investigate the correlation between patient-reported allergies and preoperative Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Patient-Reported Outcomes Measurement System (PROMIS) scores. Methods: All patients undergoing elective cervical, lumbar procedures between May 2017 and October 2018 were included. Baseline demographic information was recorded, as well as all reported allergies or adverse reactions. Preoperative PROMIS, ODI, and NDI scores were recorded. Hierarchical multiple linear regressions were used to assess the relationship between total number of allergies and the preoperative pain and function scores. Results: A total of 570 patients were included (476 lumbar, 94 cervical). The mean number of allergies reported was 1.89 ± 2.32. The mean preoperative ODI and NDI scores were 46.39 ± 17.67 and 43.47 ± 16.51, respectively. The mean preoperative PROMIS Physical Health and PROMIS Mental Health scores were 37.21 ± 6.54 and 43.89 ± 9.26, respectively. Hierarchical multiple linear regression showed that total number of reported allergies shared a statistically significant negative relationship with all of the following scores: ODI ( B = 0.83, P = .02), NDI ( B = 1.45, P = .02), PROMIS Physical Health ( B = −0.29, P = .013), and PROMIS Mental Health ( B = −0.38, P = .024). Conclusions: Patient-reported allergies share a statistically significant negative relationship with preoperative pain and function scores; as patients have increasing total number of allergies, the ODI/NDI scores become worse (increase) and the PROMIS scores become worse (decrease).

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Patient-reported allergies cause inferior outcomes after total knee arthroplasty

Abstract: I.

Cited by 30 publications

References 29 publications

Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature

Predicting the Outcome of Total Knee Arthroplasty Using the WOMAC Score: A Review of the Literature

Allergic Status Is a Confounder for Inpatient Length of Stay and Outcome Analysis

Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery

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