Risk Factors And Complications Analysis Of Total Knee Arthroplasty In Patients With Metabolic Syndrome Associated Osteoarthritis: A 10-year Retrospective Study Of A National Inpatient Sample Database.

Objective: This study aimed to evaluate the trends in Metabolic Syndrome-associated Osteoarthritis (MetS-OA) among patients undergoing Total Knee Arthroplasty (TKA) and to identify key risk factors associated with this condition. Methods: A retrospective analysis was conducted using data from the Nationwide Inpatient Sample (NIS) from 2009 to 2019. The study examined patient demographics, hospital characteristics, length of stay (LOS), total hospitalization costs, in-hospital mortality rates, comorbid conditions, and perioperative complications. Multivariable logistic regression analysis was utilized to explore the relationship between MetS-OA and medical outcomes in TKA patients. Results: Out of 1,361,454 TKA procedures analyzed, 1,330,399 unique patients were included. The overall incidence of MetS-OA was 16.1%, with an upward trend from 2011 to 2019. Key risk factors forMetS-OA inTKA patients included advanced age, male gender, non-White racial backgrounds, and comorbidities such as chronic pulmonary disease, depression, and hypothyroidism. Patients with MetS-OA experienced longer hospital stays and incurred higher median hospitalization costs by $1,445.50, though no significant increase in mortality was observed. Besides, MetS-OA patients were more likely to experience postoperative complications, including acute myocardial infarction, severe malnutrition, acute cerebrovascular disease, postoperative delirium, acute respiratory distress syndrome (ARDS), prolonged mechanicalventilation, pneumonia, urinary tract infections, acute renal failure, and surgical complications such as lower limb nerve injury. Conclusion: The incidence of MetS-OA among TKA patients is increasing, with several patient- and hospital-related factors significantly influencing the risk of postoperative complications. Preoperative optimization of high-risk patients and the implementation of standardized treatment protocols for MetS-OA may help reduce adverse events, improve patient outcomes, and lower healthcare costs.