Individuals with Down syndrome are living longer than ever before, as the average life expectancy is 60 years and climbing. It’s also a reality that Down syndrome is associated with an increased risk of different musculoskeletal problems, some of which are best treated with a surgical procedure. Not surprisingly, information on surgical outcomes and best practices for serving this group is lacking, but a recent study by researchers at Yale wanted to change that.
Yale researchers wanted to learn more about the unique challenges faced by individuals with Down syndrome and their doctors when it comes to hip and knee replacement procedures. Recently, they examined surgical outcomes for patients with Down syndrome who were undergoing joint replacement and compared the results to a control population. We explore their findings in today’s blog.
Down Syndrome And Joint Replacement
For their study, researchers looked at a massive multi-insurance administrative claims database that contained a cohort of 151 million patients at the time of the study. They first identified patients who had undergone a total hip or total knee replacement between 2010 and 2021, then they performed an additional search for patients with Down syndrome that met the first criteria. They identified 492,551 patients without Down syndrome and 157 patients with Down syndrome who received a hip replacement. They identified 1,152,719 patients without Down syndrome and 151 with Down syndrome who received a knee replacement. Patients with Down syndrome were then matched as appropriately as possible to a patient without Down syndrome to make the populations as similar as possible.
Next, researchers looked at the 90-day postoperative outcomes and two-year revisional rates between the two groups. Researchers were encouraged to find that there existed no difference in the need for revisional surgery, suggesting that the operation itself was typically successful across both patient groups. However, differences arose when examining adverse events. Patients with Down syndrome were more likely to experience adverse events like:
- Sepsis
- Urinary tract infections
- Acute kidney injury
- Pneumonia
Researchers believe these increased risks are tied to the fact that Down syndrome is oftentimes associated with an increased risk of immunodeficiencies, which could make a patient more susceptible to these issues.
Additional Post-Op Monitoring Recommended
The good news from the study is that joint replacement surgery is largely successful for patients with Down syndrome, and doctors, patients and their families should not shy away from the procedure if it stands to significantly improve a person’s quality of life. With that said, patients with Down syndrome require more post-op monitoring to check for possible signs of adverse events. Many of these issues respond more positively to treatment when the problem is caught at an early stage, and since this group is at a heightened risk for issues, additional monitoring should become the norm.
No matter what issues you face, Dr. Botero and his team are committed to providing you with the highest level of care and post-operative monitoring to ensure that your surgery and recovery go as expected. We know how much patients stand to gain from a successful joint replacement procedure, so let us help improve your quality of life and keep you active for years to come. For more information, or for help with a different hip or knee issue, reach out to our team today at (865) 558-4444.
