The Impact of Celiac Disease on Complication Rates After Total Joint Arthroplasty: A Matched Cohort Study

• Authors: Matthew W Cole, Tulane University School of Medicine; Bailey J Ross, Emory University School of Medicine; Lacee K Collins, Tulane University School of Medicine; Onyebuchi Imonugo, Tulane University School of Medicine; William F Sherman, Tulane University School of Medicine
• Journal Title: Arthroplasty Today
• Volume: Volume 17
• Publisher: Elsevier Inc | 2022-10-01, Pages 205-210.e3
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.artd.2022.08.001
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Arthroplasty; Knee; Hip; Celiac disease; Complications

Abstract

Background: While many studies have demonstrated increased complication risk after total joint arthroplasty in patients with inflammatory bowel disease, it is unclear if celiac disease is associated with similarly increased risk. The purpose of this study was to analyze if celiac disease is associated with increased postoperative complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods: A retrospective cohort study was conducted using the PearlDiver database. Patients with celiac disease who underwent THA (n = 1701) and TKA (n = 3515) were matched 1:3 with controls (THA, n = 5103; TKA, n = 10,545) on age, sex, year of arthroplasty, diabetes mellitus, tobacco use, and obesity. Rates of medical complications within 90 days and joint complications including revision arthroplasty, prosthetic joint infection, periprosthetic fracture, and aseptic loosening within 2 years postoperatively were queried. Complication rates were compared for patients with celiac disease vs controls with multivariable logistic regression. Results: After primary THA, patients with celiac disease exhibited significantly higher rates of acute myocardial infarction within 90 days (2.7% vs 1.9%; odds ratio 1.45; 95% confidence interval 1.01-2.07) and periprosthetic fractures at 2 years postoperatively (1.1% vs 0.5%; odds ratio 2.09; 95% confidence interval 1.14-3.79) than controls. Following primary TKA, patients with celiac disease exhibited higher but statistically comparable complication rates than controls (all P >. 05). Conclusions: Celiac disease was associated with significantly higher rates of acute myocardial infarction and periprosthetic fracture after primary THA. Complication rates after primary TKA were similar between the cohorts. Level of Evidence: Level III.