Gout Risk After Total Knee Arthroplasty: A Propensity-score-matched Cohort Study

Abstract

Background/aim: Gout, characterized by acute inflammatory symptoms and monosodium urate crystal deposits in joints, is prevalent among males and the elderly. Total knee arthroplasty (TKA) is a common treatment for knee osteoarthritis (OA), but its impact on the risk of developing gout is unclear. This study examined the risk of gout in patients undergoing TKA.

Patients and methods: Utilizing the TriNetX research network, a retrospective cohort study was conducted on OA patients without prior gout. The TKA cohort was compared to a non-TKA control group using propensity score matching to balance covariates. The primary outcome was the incidence of gout over a five-year follow-up period.

Results: The study included 38,834 matched pairs of TKA and non-TKA patients. TKA patients had a 15.6% higher risk of developing gout (HR=1.156; 95%CI=1.042-1.284) compared to controls. Sensitivity analyses confirmed the increased risk across various models and follow-up durations.

Conclusion: TKA is associated with a higher risk of developing gout, particularly in females and older adults. Clinicians should monitor and manage gout risk in TKA patients, emphasizing preventive measures and early intervention. Further research is needed to understand the underlying mechanisms and improve patient care post-TKA.

Keywords: Gout; epidemiology; real-world study; total knee arthroplasty.