Metabolic Syndrome Does Not Increase Risk of Revision After Hip and Knee Arthroplasty: Study

A recent study published in the The Journal of Arthroplasty explored the debated impact of metabolic syndrome (MetS) on the risk of revision surgeries after hip and knee arthroplasty by focusing on the short-term risk (minimum of 2.7 years) of revisions due to periprosthetic joint infection (PJI). The study also examined the risk of revision due to any other cause and overall mortality rates.

The research was conducted from May 2017 to November 2019 which followed a cohort of 2,901 patients who underwent a total of 3,024 hip and knee arthroplasties. Among these patients, 62.1% met the criteria for MetS. This research utilized data from national registries and a local database to determine the presence of MetS and to track revision surgeries with a follow-up period of at least two years and eight months. The statistical analyses, including Cox regression, were employed to calculate hazard ratios (HR), 95% confidence intervals (CI), and P-values. 

The outcomes of this analysis releaved that the patients with MetS did not show an increased risk of periprosthetic joint infection. Also, no instances of PJI were reported in patients without MetS who received knee arthroplasties. The overall risk of requiring any type of revision surgery was not significantly different between MetS patients and non-MetS patients. The study found no significant difference in mortality risk for MetS patients when compared to non-MetS patients. However, an increased in the mortality risk was observed in MetS patients who underwent knee arthroplasty, unlike the individuals who underwent hip arthroplasty. Analysis of morbid obesity (body mass index over 40), gender (men), and diabetes did not indicate an elevated risk of PJI.

The findings of this research suggest that MetS does not increase the risk of revision surgery due to PJI in patients who were undergoing hip and knee arthroplasty. The general risk of revision surgery was not elevated in MetS patients which makes hip and knee arthroplasty a potential option for the individuals with MetS. However, the increased mortality risk observed in MetS patients who received knee arthroplasty warrants further investigation to understand the underlying causes and reduce potential risks. These results provides valuable insights for surgeons and patients with MetS by emphasizing that hip and knee arthroplasty can be safely performed without an increased risk of revision surgery.

Source:

 Reinholdt Sørensen R, Timm S, Rasmussen LE, Brasen CL, Varnum C, Metabolic Syndrome and Morbid Obesity are Not Risk Factors for Revision Surgery in Patients Undergoing Hip and Knee Arthroplasty, The Journal of Arthroplasty (2024). https://doi.org/10.1016/j.arth.2024.07.013.