Risk Factors for Manipulation After Total Knee Arthroplasty: A Pooled Electronic Health Record Database Study

Pfefferle, Kiel J.; Shemory, Scott; Dilisio, Matthew F.; Fening, Stephen D.; Gradisar, Ian

doi:10.1016/j.arth.2014.05.001

Cited by 77 publications

(37 citation statements)

References 27 publications

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“…Furthermore, patients with arthrofibrosis and psychological distress perceived themselves as having worse knee scores and overall health, but the rate of MUA was not evaluated [27]. Pfefferle and colleagues utilized the Explorys software to mine national healthcare databases and found that depression was not associated with an increase in MUA [28], similar to the findings in this study. In fact, a diagnosis of depression significantly decreased the need for MUA.…”

Section: Discussionsupporting

confidence: 86%

Psychiatric disorders increase complication rate after primary total knee arthroplasty

et al. 2016

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Section: Discussionsupporting

confidence: 86%

Psychiatric disorders increase complication rate after primary total knee arthroplasty

et al. 2016

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“…The Explorys platform was used in previous studies to analyze large cohorts of patients. 20,21 The medical records of 26 million patients were available through the Explorys platform, and 1.2 million of these patients had a diagnosis of low back pain. This resulted in a prevalence of 4.54% for the study period, lower than previously reported.…”

Section: Discussionmentioning

confidence: 99%

Modifiable Risk Factors in Patients With Low Back Pain

Shemory¹,

Pfefferle²,

Gradisar³

2016

Orthopedics

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Low back pain is one of the most common reasons for physician visits in the United States and is a chief complaint frequently seen by orthopedic surgeons. Patients with chronic low back pain can experience recurring debilitating pain and disability, decreasing their quality of life. A commercially available software platform, Explorys (Explorys, Inc, Cleveland, Ohio), was used to mine a pooled electronic health care database consisting of the medical records of more than 26 million patients. According to the available medical history data, 1.2 million patients had a diagnosis of low back pain (4.54%). The information was used to determine the incidence of low back pain in patients with a history of nicotine dependence, obesity (body mass index, >30 kg/m(2)), depressive disorders, and alcohol abuse. Relative risk was then calculated for the defined modifiable risk factors. Patients with nicotine dependence, obesity, depressive disorders, and alcohol abuse had a relative risk of 4.489, 6.007, 5.511, and 3.326 for low back pain, respectively, compared with patients without the defined risk factor. A statistically significant difference was found in the incidence of low back pain between all 4 groups with the risk factors evaluated and the general population (P<.05). By determining treatable patient risk factors for low back pain, physicians can monitor at-risk patients and focus on prevention and control of debilitating disease. These approaches can decrease the number of patients with isolated low back pain who are seen by orthopedic surgeons. [Orthopedics. 2016; 39(3):e413-e416.].

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“…1). Seven studies were included for analysis [4,8,12,[16][17][18][19] (Table 1). Patients in these studies with and without DM were treated similarly with regard to postoperative physiotherapy.…”

Section: Resultsmentioning

confidence: 99%

Diabetes mellitus does not increase the risk of knee stiffness after total knee arthroplasty: a meta-analysis of 7 studies including 246 053 cases

Jump

Malik

Anand

et al. 2019

Knee Surg & Relat Res

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Purpose: The association of diabetes mellitus with knee stiffness after total knee arthroplasty is still being debated. The aim of this study was to assess through meta-analysis the impact of diabetes mellitus on the prevalence of postoperative knee stiffness after total knee arthroplasty. Methods: We conducted a literature search for terms regarding postoperative knee stiffness and diabetes mellitus on Embase, CINAHL, and PubMed NCBI. Results: Of 1142 articles, seven were suitable for analysis. Meta-analysis showed that diabetes mellitus does not confer an increased risk of primary or revision total knee arthroplasty-induced postoperative knee stiffness when compared to nondiabetic patients (primary total knee arthroplasty, estimated odds ratio [OR] 1.474 and 95% confidence interval [CI] 0.97-2.23; primary and revision total knee arthroplasty, OR 1.340 and 95% CI 0.97-1.83). Conclusion: There is no strong evidence that diabetes mellitus increases the risk of knee stiffness after total knee arthroplasty. The decision to proceed with total knee arthroplasty, discussion as part of the consent process, and subsequent rehabilitation should not differ between patients with and without diabetes mellitus with regards to risk of stiffness. Level of evidence: Level III (meta-analysis)

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Risk Factors for Manipulation After Total Knee Arthroplasty: A Pooled Electronic Health Record Database Study

Cited by 77 publications

References 27 publications

Psychiatric disorders increase complication rate after primary total knee arthroplasty

Psychiatric disorders increase complication rate after primary total knee arthroplasty

Modifiable Risk Factors in Patients With Low Back Pain

Diabetes mellitus does not increase the risk of knee stiffness after total knee arthroplasty: a meta-analysis of 7 studies including 246 053 cases

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