10 Apr 2023 • Patients with low sodium levels before or after total knee or hip arthroplasty are more likely to experience complications and other adverse outcomes, reports a study in The Journal of Bone & Joint Surgery. The researchers analyzed 3,071 primary and revision TJAs performed between 2015 and 2017. All patients had at least one preoperative and one postoperative sodium measurement, average age was 67 years, and 54% were women.

• Postoperative hyponatremia was linked to increases in several adverse outcomes – particularly in patients who had low sodium levels both before and after TJA.
• After adjustment for other factors, the risk of a complication was 2.1 times higher among patients who had hyponatremia postoperatively and 2.6 times higher among patients who had hyponatremia both preoperatively and postoperatively.
• Patients with postoperative hyponatremia were also more likely to have a non-home discharge (1.7 and 3.0 times higher among those with normal and low preoperative sodium, respectively) and spent more days in the hospital after surgery.

The study adds to previous evidence that hyponatremia is relatively common following TJA and can adversely affect the patients’ postoperative course. “Patients who develop hyponatremia are likely to stay in the hospital longer and are more likely to experience complications and undergo non-home discharge,” Dr. Parvizi and coauthors write.

Source: The Journal of Bone & Joint Surgery | Read full article