Long-term results of hip and knee arthroplasty in patients with polymorbidity

Introduction. We analyzed the quality of life (QoL) in patients with osteoarthritis after total knee arthroplasty (TKA) and total hip arthroplasty (THA). We compared the groups of patients with polymorbidity and without severe concomitant disease.Objective: The aim of the study was to determine in patients with osteoarthritis the long-term results of TKA and THA and the patients QoL depending on concomitant pathology.Materials and methods. In Group I was 806 patients (19-88 years) with hip os-teoarthritisafter primary THA in the Department of Traumatology andOrthopedic Surgery of the North-Western State Medical University named after I.I. Mechnikov in 2014-2018. In Group II was 376 patients (43-85 years) with knee osteoarthritis after primary TKA in the Department of Traumatology of the State Budgetary Institution of Healthcare of the Republic of Kazakhstan of the Republican Hospital named after. V.A.Baranova (Petrozavodsk) in 2016 - 2019. Statistical analysis and graphics creation were performed using the R programming language (https://cran.r-project.org)Results: The probability of excellent and good QoL after THA was 0.89 (0.81; 0.94) after 5-year follow-up in patients without comorbidity. In patients with concomitant pathology 0,86 (0,81;0,94) The probability of excellent and good QoL in 5th year of follow-up with ASA I was 0.76 (0.65; 0.87); with ASA II - 0.82 (0.75; 0.87); according to ASA III - 0.72 (0.63; 0.80). The worst results were in patients with ASA IV 0.25 (0.12; 0.65). Statistically significant differences in survival curves between groups were only in patients with ASA IV, as indicated by the log-rank test (χ2 = 0.93551, p-value= 0.0283). Conclusions. 1. In 5 years after THA, the excellent and good QoL have only 85% of patients, satisfactory and unsatisfactory - 15% of patients. 2. The QoL in 5 years after THA is worse in older female with severe comorbidity, however, these differences are not statistically significant (р>0,05), but we have a tendency and it requires new research in the future.