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Herpes Zoster Risk After Total Knee Replacement: a multicenter, propensity-score-matched cohort study in the United States.
Liao, Wen-Chieh; Lo, Shao-Wei; Wu, Chih-Lung; Juang, Sin-Ei; Chang, Hui-Chin; Gau, Shuo-Yan; Li, Chen-Pi.
Afiliación
  • Liao WC; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
  • Lo SW; Doctoral Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
  • Wu CL; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Juang SE; Department of Orthopedic Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan.
  • Chang HC; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
  • Gau SY; Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
  • Li CP; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Int J Med Sci ; 21(12): 2244-2251, 2024.
Article en En | MEDLINE | ID: mdl-39310252
ABSTRACT

Background:

Total knee replacement (TKR) is a common surgical procedure for osteoarthritis (OA) patients. TKR may increase susceptibility to herpes zoster (HZ) by inducing immunosuppression, surgical stress, and nerve injury. However, limited data exist on the relationship between TKR and HZ. This study examined the risk of HZ over time among OA patients who underwent TKR and those who did not, using a large population-based cohort.

Method:

Utilizing the TriNetX research network, people with OA and underwent TKR were recruited as case group. After 11 propensity score matching, OA patients who never experienced TKR were included as control group. Covariates, including demographics, comorbidities, and laboratory data, were balanced using propensity score matching. A 5-year follow-up assessed the hazard ratio of incident HZ and related complications.

Results:

Compared to the control group, a significantly elevated risk of HZ was observed in the TKR cohort across 5-year follow-up period, with the hazard ratio of 1.223 (95% CI 1.089-1.373). Zoster without complications presented 1.173-fold risk in TKR patients while comparing with non-TKR controls. However, most other secondary outcomes related to HZ complications-such as encephalitis, neurological involvement, ocular disease, and disseminated zoster-did not show a significant increase in risk. The risk of HZ was statistically significant for females and older adults in the TKR cohort than in the control cohort.

Conclusions:

OA patients who underwent TKR had an increased risk of HZ compared to those who did not receive the procedure, especially females and older adults. These findings highlight the need for HZ monitoring/prevention protocols and further research on mitigating viral reactivation after major joint surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla / Puntaje de Propensión / Herpes Zóster Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Int J Med Sci Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla / Puntaje de Propensión / Herpes Zóster Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Int J Med Sci Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Australia