SummaryBackgroundDemand for total hip and knee arthroplasty procedures continues to rise. Ongoing changes in surgical care and patient populations require continued monitoring of outcome trends. Using nationwide data from the USA, we aimed to describe updated trends in patient and peri‐operative care characteristics as well as complications among total hip and knee arthroplasty recipients.MethodsWe included patients who underwent elective primary total hip or knee arthroplasty between 2016 and 2021. Trends were reported for a variety of patient and peri‐operative care characteristics as well as complications.ResultsWe identified significant trends in patient and peri‐operative care characteristics as well as the incidence of complications. While patient median age increased, demographic composition remained consistent over the time period studied. There was a shift towards outpatient total hip and knee arthroplasty procedures, with one in five performed in the outpatient setting in 2021; the median duration of hospital stay decreased by 1 day over the time period for both procedures. Parallel increasing trends of total procedure numbers were found for patients without comorbidities and those with ≥ 3 comorbidities. Postoperative mortality increased significantly over the time period analysed for patients having total hip arthroplasty but not those having total knee arthroplasty (0.08 to 0.15 events per 1000 inpatient days, p = 0.037 and 0.09 to 0.33 events per 1000 inpatient days, p = 0.149, respectively).DiscussionCompared with previous trend analyses of patients having total hip or knee arthroplasty, the present study shows: an increasing rate of outpatient surgeries; increasing numbers of arthroplasty procedures in high comorbidity burden groups; and an increase incidence of certain serious postoperative complications.

中文翻译：

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美国择期全髋关节和膝关节置换术患者合并症和并发症的趋势


摘要背景对全髋关节和膝关节置换术的需求持续上升。外科护理和患者群体的持续变化需要持续监测结果趋势。使用来自美国的全国数据，我们旨在描述患者和围手术期护理特征的最新趋势以及全髋关节和膝关节置换术受者的并发症。方法我们纳入了 2016 和 2021 年间接受择期初次全髋关节或膝关节置换术的患者。报告了各种患者和围手术期护理特征以及并发症的趋势。结果我们确定了患者和围手术期护理特征以及并发症发生率的显着趋势。虽然患者中位年龄增加，但人口构成在研究的时间段内保持一致。转向门诊全髋关节和膝关节置换术，2021 年有五分之一在门诊进行;两种手术的中位住院时间在一段时间内减少了 1 天。对于无合并症的患者和有 ≥ 3 种合并症的患者，发现总手术次数呈平行增加趋势。在分析的时间段内，全髋关节置换术患者的术后死亡率显著增加，但全膝关节置换术患者的术后死亡率没有增加（分别为每 1000 住院天数 0.08 至 0.15 个事件，p = 0.037 和 0.09 至 0.33 个事件/1000 住院天数）。讨论与之前对全髋关节或膝关节置换术患者的趋势分析相比，目前的研究表明：门诊手术率增加;高合并症负担组的关节置换术数量增加;以及某些严重术后并发症的发生率增加。