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Gout is associated with increased healthcare utilization after knee arthroplasty
  1. Jasvinder A Singh1,2,3,
  2. John David Cleveland2
  1. 1 Medicine Service, VA Medical Center, Birmingham, Alabama, USA
  2. 2 Department of Medicine at School of Medicine, University of Alabama, Birmingham, Alabama, USA
  3. 3 Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, Alabama, USA
  1. Correspondence to Dr Jasvinder A Singh, Department of Medicine at School of Medicine, University of Alabama, Birmingham, AL 35294-0022, USA; jasvinder.md{at}gmail.com

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Total knee arthroplasty (TKA) is an effective surgery for patients with advanced knee arthritis refractory to medical treatment. Gout, the most common inflammatory arthritis in adults, was associated with a 40% increased TKA risk in women in a recent population-based study.1 This was attributable possibly to accelerated cartilage wear associated with soluble urate or urate crystals. It is not known if post-TKA healthcare utilisation and complications are higher in people with gout. We assessed whether gout was associated with a higher risk of post-TKA healthcare utilisation and in-hospital complications.

We used the 1998–2014 US National Inpatient Sample data, a 20% stratified sample of discharges from US community hospitals.2 We used validated International Classification of Disease, ninth revision, common modification (ICD-9-CM) code to identify the primary TKA cohort (81.54)3, with TKA as the primary procedure and among these people with and without gout (274).4 Study outcomes post-primary TKA were (1) healthcare utilisation, length of hospital stay (>3 days) and the discharge disposition, that is, to home versus rehabilitation/in-patient facility; and (2) in-hospital postoperative complications identified by respective ICD-9-CM codes for transfusion, revision or infection, …

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