Arch Orthop Trauma Surg. 2025 Apr 5;145(1):226. doi: 10.1007/s00402-025-05846-4.
ABSTRACT
INTRODUCTION: Crohn’s disease has been increasing in incidence globally and has several musculoskeletal manifestations including large joint arthritis. This study compares post-operative lengths of stay, healthcare costs, and complication rates between patients with and without Crohn’s Disease (CD) following Total Hip Arthroplasty (THA).
METHODS: Data were collected from the National Inpatient Sample Database Healthcare Cost and Utilization Project between the years 2016-2019. Patients with Crohn’s Disease (CD) and without Crohn’s Disease (NCD) undergoing THA were identified using International Classification of Diseases, 10th revision codes (ICD-10-CM/PCS). Length of stay, total cost, and medical and surgical complications were examined during this time period. SPSS (v 27.0 8, IBM Corp. Armonk, NY) was utilized to compare demographic and analytical statistics between CD and NCD patients undergoing THA.
RESULTS: 1,171 (0.32%) CD and 366,219 (99.68%) NCD patients undergoing THA were included. Compared to NCD patients, CD patients were more likely to be Caucasian (p < 0.05), younger (p < 0.001), non-obese (p = 0.022), non-emergently admitted (p = 0.04), and have longer lengths of stay (p < 0.001). Furthermore, CD patients had higher risks of acute renal failure (OR = 1.43, p = 0.025), acute blood loss anemia (OR = 1.431, p < 0.001), blood transfusion (OR = 1.73, p < 0.001), pneumonia (OR = 2.607, p = 0.005), deep vein thrombosis (OR = 2.81, p = 0.035), periprosthetic infection (OR = 1.57, p = 0.05), and length of stay greater than 2 days (OR = 1.293, p < 0.001). However, CD patients had lower risk of periprosthetic mechanical complication (OR = 0.218, p = 0.011).
CONCLUSION: This study demonstrates that CD patients undergoing THA are younger, have longer lengths of stay, and have greater rates of both local and systemic complications than NCD patients undergoing THA. As such, this study will aid in surgical candidate selection and proper operative planning for CD patients undergoing THA. Furthermore, future studies investigating the mechanisms behind these differences in post-operative outcomes can help to further advance orthopedic care for CD patients.
PMID:40186766 | DOI:10.1007/s00402-025-05846-4
