Effect of Lower Extremity Osteoarthritis on Outcomes of Lumbar Decompression

J Am Acad Orthop Surg Glob Res Rev. 2023 Oct 19;7(10):e23.00044. doi: 10.5435/JAAOSGlobal-D-23-00044. eCollection 2023 Oct 1.

Abstract

Background: The purpose of this study is to evaluate how hip or knee osteoarthritis (OA) and total joint arthroplasty impact the outcomes of patients undergoing lumbar decompression.

Methods: A retrospective review of 342 patients undergoing lumbar decompression without fusion from January 2019 and June 2021 at a single institution was performed. Univariate and multivariate analyses were used to compare outcomes between patients with and without concomitant hip or knee OA.

Results: Forty-six percent of patients had a hip or knee OA diagnosis and were higher risk as they were older, had higher BMIs, were more likely to be former smokers, had higher ASA scores, and were more likely to undergo 3+ level surgery. Postoperatively, after adjusting for differences between groups, hip or knee OA patients were more likely to be readmitted (OR=12.45, p=0.026) or have a complication (OR=13.77, p=0.031). However, patient reported outcomes as measured by Patient Reported Outcomes Measurement Information System-physical function. were similar at 1-3 months and 3-6 months. Higher levels of physical function were observed at 3-6 months postoperatively in hip OA patients with a history of THA.

Conclusion: Patients with concomitant hip or knee OA are at higher risk for readmission and postoperative complications but may achieve similar levels of physical function as those without OA.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee*
  • Decompression
  • Humans
  • Lower Extremity
  • Osteoarthritis, Hip* / etiology
  • Osteoarthritis, Hip* / surgery
  • Osteoarthritis, Knee* / complications
  • Osteoarthritis, Knee* / surgery
  • Treatment Outcome