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Comorbidity indices in orthopaedic surgery: a narrative review focused on hip and knee arthroplasty

Journal

EFORT OPEN REVIEWS
Volume 6, Issue 8, Pages 629-640

Publisher

BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/2058-5241.6.200124

Keywords

comorbidity; hip arthroplasty; knee arthroplasty

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Comorbidity indices used in orthopaedic surgery were originally developed for non-orthopaedic patients and are now commonly used. With the increasing rate of hip and knee arthroplasty, understanding the impact of comorbid diseases on postoperative outcomes is crucial. Therefore, developing an updated and standardized approach for comorbidity assessment and reporting is essential.
Comorbidity indices currently used to estimate negative postoperative outcomes in orthopaedic surgery were originally developed among non-orthopaedic patient populations. While current indices were initially intended to predict short-term mortality, they have since been used for other purposes as well. As the rate of hip and knee arthroplasty steadily rises, understanding the magnitude of the effect of comorbid disease on postoperative outcomes has become increasingly more important. Currently, the ASA classification is the most commonly used comorbidity measure and is systematically recorded by the majority of national arthroplasty registries. Consideration should be given to developing an updated, standardized approach for comorbidity assessment and reporting in orthopaedic surgery, especially within the setting of elective hip and knee arthroplasty.

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