Fibromyalgia increases the risk of Surgical Complications following Total Knee Arthroplasty: A Nationwide Database Study

Abstract Background Although f ibromyalgia is a common comorbidity with knee osteoarthritis, the orthopaedic literature on this population is limited. Therefore, the purpose of this study was to assess if fibromyalgia patients have a higher likelihood of developing surgical complications after total knee arthroplasty (TKA) than a matched control cohort. Methods The Medicare Standard Analytical Files of the PearlDiver supercomputer was utilized to identify patients who underwent a TKA between 2005 and 2014. Patients were 1:1 propensity score matched based on the diagnosis of fibromyalgia, age, sex, and the Charlson Comorbidity Index, yielding a total of 305,510 patients. Odds ratios, 95% confidence intervals (95% CI) and p -values ( Results Compared to a matched cohort, fibromyalgia patients had increased odds of developing any surgical complication (OR: 1.55, 95%CI: 1.51 to 1.60, p p =0.046); mechanical loosening (OR: 1.34, 95%CI: 1.26 to 1.53, p p p Conclusion This analysis of over 300,000 patients identified that fibromyalgia patients can have a greater risk of developing certain surgical complications after TKA. Therefore, fibromyalgia patients must be made aware of the increased post-operative risks and surgeons should consider enhanced pre-operative medical and surgical optimization.