Background/Purpose: Chronic obstructive pulmonary disease (COPD) is a condition which causes a substantial burden to patients, physicians, and the healthcare system at large. Medical comorbidities are commonly associated with adverse health outcomes in the postoperative period. Here, we present a large database review of patients undergoing total knee arthroplasty (TKA) to determine the effect of COPD on patient outcomes.

Methods: The PearlDiver database was queried for all patients who underwent TKA between 2007 and the first quarter of 2017.  Medical complications, surgical complications, 30-day readmission rates, revision rates, and opioid utilization were assessed at various intervals following TKA.

Results: 46,769 TKA patients with COPD and 120,177 TKA patients without COPD were studied. TKA patients with COPD experienced increased risk of 30-day readmission (40.8% vs. 32.2%, p< 0.0001), 30-day total medical complications (10.2% vs. 7.0%, p< 0.0001), prosthesis explanation at 6 months (0.4% vs. 0.2, p=0.0130), 1 year (0.6% vs. 0.3%, p=0.0005), and 2 years (0.8% vs. 0.5%, p=0.0003), as well as an increased rate of revision (p< 0.0046) compared to TKA patients without COPD. Opioid utilization of TKA patients with COPD was greater than that of TKA patients without COPD at 3,16 and 12 months.

Conclusion: Patients with COPD have an increased risk for medical and surgical complications, readmission, and prolonged opioid use following TKA. Patients undergoing TKA with a history of COPD represent a high-risk patient population, and it is prudent to ensure that such patients are fully optimized in the perioperative period to reduce complications and minimize health-care costs.

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/chronic-obstructive-pulmonary-disease-associated-with-prolonged-opiate-use-increased-short-term-complications-and-the-need-for-revision-surgery-following-total-knee-arthroplasty/