Inflammatory bowel disease is associated with an increased risk of adverse events in patients undergoing joint arthroplasty

Aims The present study aimed to investigate whether patients with inflammatory bowel disease (IBD) undergoing joint arthroplasty have a higher incidence of adverse outcomes than those without IBD. Methods A comprehensive literature search was conducted to identify eligible studies reporting post-operative outcomes in IBD patients undergoing joint arthroplasty. The primary outcomes in-cluded postoperative complications, while the secondary outcomes included unplanned re-admission, length of stay (LOS), joint reoperation/implant revision, and cost of care. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model when heterogeneity was substantial.Results Eight retrospective studies involving 29,738 patients with IBD were included. Compared with non- IBD controls, patients with IBD were significantly more likely to have overall com-plications (OR 2.11 (95% CI 1.67 to 2.66), p < 0.001), medical complications (OR 2.15 (95% CI 1.73 to 2.68), p < 0.001), surgical complications (OR 1.43 (95% CI 1.21 to 1.70), p < 0.001), and 90 -day readmissions (OR 1.42 (95% CI 1.23 to 1.65), p < 0.001). The presence of IBD was positively associated with the development of venous thromboembolism (OR 1.60 (95% CI 1.30 to 1.97), p < 0.001) and postoperative infection (OR 1.95 (95% CI 1.51 to 2.51), p < 0.001). In addition, patients with IBD tended to experience longer LOS and higher costs of care.Conclusion The findings suggest that IBD is associated with an increased risk of postoperative complica-tions and readmission after joint arthroplasty, resulting in longer hospital stay and greater fi-nancial burden. Surgeons should inform their patients of the possibility of adverse outcomes prior to surgery and make appropriate risk adjustments to minimize potential complications.

Automated summary

This study investigated whether patients with inflammatory bowel disease (IBD) undergoing joint arthroplasty have a higher incidence of adverse outcomes compared to those without IBD. The findings suggest that IBD is associated with an increased risk of postoperative complications, including overall complications, medical complications, surgical complications, and 90-day readmissions. Patients with IBD also tend to have longer hospital stays and higher costs of care.