The impact of past surgical history on postoperative outcomes following primary total joint arthroplasty: a retrospective study

Background: Currently, there is little data regarding a patient's prior surgical history on postoperative outcomes following primary total joint arthroplasty (TJA). Literature has indicated that surgical timing affects postoperative outcomes, with wait times possibly affecting patient recovery, function, and quality of life. The aim of this study is two-fold: (I) to identify the optimal length of time to wait following a surgical procedure prior to performing primary TJA, and (II) to determine the relationship between the number of previous surgeries within the year of a TJA and its effect on postoperative outcomes. Methods: Charts of all patients who underwent primary TJA between 2007 and 2021 at Loyola University Medical Center and affiliated hospitals were manually reviewed. Demographic variables were collected and analyzed. Time between surgeries was assessed. Primary postoperative outcomes included the 90-day complication and readmission rate. Results: A total of 3,155 patients who underwent TJA between 2007 and 2021 were included in the study. When looking at surgical history, 12.3% of patients without prior surgeries, 8.7% with one prior surgery, and 11.5% with multiple prior surgeries within the past year, respectively, experienced postoperative complications. Using multivariable regression analysis, there was no significant difference in the odds of having a complication following index surgery between patients with no prior surgeries compared to multiple prior surgeries within the year (odds ratio =0.80, 95% confidence interval: 0.43-1.5; P=0.5). Conclusions: These findings suggest the number of previous surgeries within the year and their timing is not associated with an increased risk of postoperative complications following TJA.