|
Citation
|
Mekkawy KL, Saha P, Rodriguez HC, Stafford JA, Roche MW, Corces A, Gosthe RG. J. Arthroplasty 2024; ePub(ePub): ePub. |
|
Abstract
|
INTRODUCTION: Pes planus, also known as flat foot, occurs due to the loss of the longitudinal arch of the foot. Pes planus leads to overpronation of the foot and altered gait mechanics. This may lead to an increased risk of complications following total hip arthroplasty (THA). Thus, the aim of this study was to assess the effects that pes planus has on rates of falls, implant complications, fall-related injuries, and times to revision among THA patients.
METHODS: A retrospective review of a private insurance claims database was conducted from 2010 to 2021. Patients who had a diagnosis of congenital or acquired pes planus and cases of THA were identified. Patients undergoing THA with a prior diagnosis of pes planus were matched to control patients 1:5 based on age, sex, and comorbidity profiles. Logistic regression was utilized to assess for differences in complication rates.
RESULTS: A total of 3,622 pes planus patients were matched to 18,094 control patients. The pes planus group had significantly higher rates of falls than the control group (6.93 versus 2.97%, OR [odds ratio]: 2.43; CI [confidence interval]: 2.09 to 2.84; P < 0.001). Pes planus patients also had significantly greater odds of dislocation (OR: 1.89; CI: 1.58 to 2.27; P < 0.001), mechanical loosening (OR: 2.43; CI: 2.09 to 2.84; P = 0.019), and periprosthetic fracture (OR: 2.43; CI: 2.09 to 2.84; P < 0.001) when compared to the control group. The pes planus group had significantly greater rates of proximal humerus fractures (P = 0.008), but no difference was seen in distal radius fractures (P = 0.102). The time to revision was significantly shorter in the pes planus group (190 versus 554 days, P < 0.001).
CONCLUSIONS: Pes planus in patients undergoing THA is associated with significantly increased fall risk, odds of implant complications, and a faster time to revision. The findings of this study may allow orthopaedic surgeons to be more attentive to identifying those patients at risk and allow for more educated patient counseling and operative planning.
Language: en |