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Contents lists available at ScienceDirect
The Journal of Arthroplasty
Complications and Costs Are Not Increased After Total Hip Arthroplasty in Patients With a History of Prostate Cancer
a Department of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
b Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
Received in revised form
Available online xxx
Background: Prostate cancer (PCa) is a largely prevalent disease in the United States. Moreover, it Methoxy-X04 is unclear whether the thromboembolic burden of disease remains present after the cancer has been treated and whether such state impacts the short-term outcomes of orthopedic procedures. Therefore, the purpose of this study is to assess 90-day postoperative complications and costs after total hip arthroplasty (THA) for osteoarthritis in patients with a history of PCa.
Methods: Two groups of patients who underwent THA for osteoarthritis in the Medicare Standard Analytical Files were identified through the PearlDiver server. Both groups were matched based on age, diabetes, smoking status, chronic kidney disease, alcohol abuse, chronic liver disease, and obesity in order to create a case-control study comparison. The 90-day complication rates after THA were compared using univariate regressions (odds ratio). We hypothesized that patients with a history of PCa would develop increased rates of thromboembolic complications based on a prolonged procoagulative state.
Results: After matching, each group was comprised of 62,571 patients. Our findings identified greater 90-day pneumonia rates for those without a history of PCa (3.26% vs 2.68%; odds ratio, 0.82). All other complications including thromboembolic diseases were clinically comparable in both groups during the 90-day postoperative period. The charges and reimbursements for the 90-day period were also comparable.
Conclusion: In our large case-control study of 125,142 patients, we found that patients with a history of PCa do not have increased risk of short-term complications after THA and that the mean 90-day re-imbursements were similar for both groups at $14,153 for PCa patients and $14,033 for those without (P ¼ .114).
The utilization of total hip arthroplasty (THA) in the aging population is predicted to increase in the following decade . While THA has been shown to reliably improve pain, physical function, vitality, and general health [2,3], the implementation of alternative payment models by the Centers for Medicare and Medicaid Services has led to a growing body of literature analyzing risk factors for complications and higher resource utilization with
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.06.052.