Mechanical complications and revision following total joint arthroplasty in acromegalic patients: A nationwide US-based study

Abstract

Background

Acromegaly is associated with significant osteoarthritis (OA) and increased risk of vertebral and hip fractures. There is limited data on total joint arthroplasty (TJA) outcomes in patients with acromegaly.

Methods

In this retrospective study, we identified patients with acromegaly who underwent total hip arthroplasty (THA), total knee arthroplasty (TKA), and total shoulder arthroplasty (TSA) between 2010 and 2022 using the PearlDiver national database. Patients with a prior history of osteoporosis and follow-up duration of less than one year were excluded. Non-acromegalic control groups were selected through matching based on confounding factors. We compared all-cause revision and implant-related complications between the groups using R software integrated with the PearlDiver database.

Results

We identified 1440 patients with acromegaly: 665 underwent THA, 618 underwent TKA, and 157 underwent TSA. Compared to the control group (2634 THA, 2445 TKA, and 600 TSA), there was no significant association with post-op revision following THA (OR(1-year) = 0.76[0.42–1.28], OR(5-year) = 0.68[0.42–1.06]), TKA (OR(1-year) = 0.89[0.48–1.55], OR(5-year) = 0.78[0.49–1.17]), and TSA (OR(1-year) = 0.19[0.02–1.40], OR(5-year) = 0.32[0.10–1.07]). Additionally, the risk of mechanical complications did not significantly increase in patients with acromegaly, either one year or five years post-operation.

Conclusion

The study showed no significant increase in risk of revisions or mechanical complications in patients with acromegaly compared to controls. These findings bridge an important gap in the understanding of post-arthroplasty complications in patients with acromegaly and offer valuable insights into surgical expectations.