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Total knee replacement in osteoarthritis patients on reducing the risk of major adverse cardiac events: a 18-year retrospective cohort study

  • Author Footnotes
    a H.-W. Yeh and C.-H. Chan contributed equally to this study.
    H.-W. Yeh
    Footnotes
    a H.-W. Yeh and C.-H. Chan contributed equally to this study.
    Affiliations
    School of Medicine, Chang Gung University, Taoyuan City, Taiwan

    Medical Education Department, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan
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  • Author Footnotes
    a H.-W. Yeh and C.-H. Chan contributed equally to this study.
    C.-H. Chan
    Footnotes
    a H.-W. Yeh and C.-H. Chan contributed equally to this study.
    Affiliations
    Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
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  • S.-F. Yang
    Affiliations
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Y.-C. Chen
    Affiliations
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Y.-T. Yeh
    Affiliations
    School of Dentistry, Chung Shan Medical University, Taichung, Taiwan

    Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Y.-T. Yeh
    Affiliations
    School of Dentistry, Chung Shan Medical University, Taichung, Taiwan

    Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • J.-Y. Huang
    Affiliations
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • C.-B. Yeh
    Correspondence
    Address correspondence and reprint requests to: C.-B. Yeh, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
    Affiliations
    Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • C.-H. Chiu
    Correspondence
    Address correspondence and reprint requests to: C.-H. Chiu, Department of Orthopedic, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan. Fax: 886-3-3286735.
    Affiliations
    School of Medicine, Chang Gung University, Taoyuan City, Taiwan

    Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
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  • Author Footnotes
    a H.-W. Yeh and C.-H. Chan contributed equally to this study.
Published:November 16, 2021DOI:https://doi.org/10.1016/j.joca.2021.09.015

      Summary

      Objectives

      Osteoarthritis (OA) is a common degenerative joint disease, and total knee replacement (TKR) is a successful surgical intervention for knee OA treatment. However, the risks of mortality and major cardiovascular events (MACEs) in patients receiving TKR remain unclear. This study investigated the risks of mortality and MACEs in knee OA patients who received TKR.

      Methods

      For this population-based cohort study, the Longitudinal Health Insurance Database 2000 was used. Two million individuals with knee OA defined by ICD-9-CM codes who received physical therapy between 1999 and 2017 were selected. For propensity score matching (PSM), we considered the year of knee OA diagnosis, demographics, comorbidities, co-medications, and knee OA–related hyaluronic acid or physical therapy at baseline. After PSM, regression analyses were performed to assess the association of mortality or MACEs with TKR and non-TKR individuals.

      Results

      We identified patients (n = 189,708) with a new diagnosis of knee OA between 2000 and 2017. In total, 10,314 propensity-score-paired TKR and non-TKR individuals were selected. The PSM cohort algorithm revealed that the risk of mortality or MACEs was lower in the TKR group (adjusted hazard ratio: 0.791; 95% confidence interval: 0.755–0.830) than in the non-TKR group.

      Conclusions

      Patients with knee OA who received TKR had decreased risks of mortality and MACEs than those who did not receive TKR. Moreover, the TKR group received a reduced dosage of nonsteroidal anti-inflammatory drugs at the 1-year follow-up.

      Keywords

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