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Metabolic disorder increases complications after joint replacement

Three or more metabolic syndrome risk factors linked to threefold increased risk of complications during first year

Ingrid Torjesen

Wednesday, 12 March 2014

Patients who have total joint replacement surgery are almost three times as likely to have complications within the first year if they have three or more metabolic syndrome risk factors, according to research presented to the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

The study included 168 patients with characteristics of metabolic syndrome who underwent total hip and total knee replacements. Of the 39 patients with three or more risk factors for metabolic disorder, 21 (16.3%) had complications within the first year.

Metabolic syndrome is a combination of disorders, including obesity, dyslipidaemia, hypertension and diabetes.

Obesity was found to have the largest impact on postoperative complications. Complications occurred in 16.2% of the patients with a BMI greater than 30 kg/m2. For patients with BMI below 30 kg/m2, risk for complications was only 1.6%.

The impact of BMI was even greater when combined with hypertension: 30.8% of patients with a BMI≥30kg/m2 and hypertension experienced complications.

The authors told the conference that complication rates following total joint replacement surgery could be reduced by identifying patients with these risk factors, counselling them and addressing the issues.

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