Risk of joint replacement surgery in Taiwanese female adults with systemic lupus erythematosus: a population-based cohort study

Abstract

Background Female patients with systemic lupus erythematosus (SLE) are prone to have musculoskeletal system involvement, which could lead to joint damage. However, few studies have assessed the incidence of arthroplasty in female patients with SLE. The aim of this study was to investigate the risk of total hip replacement surgery and total knee replacement surgery in patients with SLE. Methods We identified 577 female patients with newly diagnosed SLE between 2000 and 2012 using the Taiwan’s National Health Insurance Research Database. A comparison cohort was constructed with female patients without SLE in a ratio of 5:1, based on frequency matching for 10-year age interval, and index year, for each patient with SLE. Both cohorts were followed until a diagnosis of the study outcomes or the end of the follow-up period. Results Female patients with SLE showed a significantly higher incidence of receiving total hip replacement surgery (adjusted incidence rate ratio [aIRR] 6.47; P < 0.001), but not total knee replacement surgery (aIRR 1.81; P = 0.227). Moreover, age-group stratified analyses indicated a high incidence for receiving total hip replacement surgery among young female patients with SLE (aIRR 7.70; P = 0.001). Conclusion Young female patients with SLE had a high risk of receiving total hip replacement surgery, but not total knee replacement surgery.

A systematic review and meta-analysis comparing complications following total hip arthroplasty for systemic lupus erythematosus versus for non-systemic lupus erythematosus

“…Demographics and clinical outcomes were summarized in Tables 1 Tables 2. Among the ten screened citations, seven were the case-control studies [7,11,14,15,17,23,24], two were retrospective [18,25], and one was cohort studies a study [10]. A total of 29573 hips in the SLE group were studied compared to 4013027 hips in the non-SLE group.…”

“…Periprosthetic fracture. Four studies [7,15,17,24]reported periprosthetic fracture on events following THA. After the heterogeneity test (OR 4.50,95% CI 0.43 to 46.97, I 2 = 98% > 50%, P < 0.1), it shows that the heterogeneity between the documents selected in this study is statistically signi cant, so we chose a random effect model, and it is necessary to nd the heterogeneity.…”

“…[3]Some studies have reported several complications of total hip replacement in patients with SLE and postoperative Harris hip scores (HHS) and other functional scoring results. [7][8][9][10][11][12][13][14][15][16] At present, there is no clear consensus on the impact of complications after THA in patients with SLE. Patients with SLE undergoing THA are widely considered to have an increased risk of postoperative complications.…”

Hip Arthroplasty in Patients With Systemic Lupus Erythematosus

“…Chen и соавт. [63], у пациенток с СКВ потребность в ТЭТБС была выше, чем у лиц без СКВ (p<0,001), особенно у лиц молодого возраста (p=0,001). Следует подчеркнуть, что в последние годы основным показанием к ТЭТБС у пациентов с СКВ стано-вится не ОН, а остеоартрит (ОА) [64,65].…”

Increased Incidence of Total Knee Replacement Surgery in Patients With Psoriasis: A Secondary Cohort Analysis of a Nationwide, Population-Based Health Claims Database

“…It can cause joint damage leading to deformity, and may require surgery to alleviate pain and restore function (4). Our previous studies have shown that patients with rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus, have increased risk of receiving total knee replacement (TKR) surgery or total hip replacement (THR) surgery (5)(6)(7). We speculated that psoriasis could also attack the joints of the knees and hips resulting in their destruction, which then lead to an increased risk of receiving TKR and THR.…”