ArticleThe archives of bone and joint surgery2025
Total Knee Arthroplasty and Homelessness: A Database Study.
Article in The archives of bone and joint surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors Associated With Surgical Site Infections in Adults Following a Replacement of Weight-Bearing Joints: A Systematic Review.International wound journal · 2026Pooled it
- Patients Experiencing Homelessness Have Higher Complication Rates After Total Shoulder Arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- The Effect of Iliotibial Band Tightness and Its Release on Postoperative Pain after Total Knee Arthroplasty in Patients with Varus Gonarthrosis: A Randomized Clinical Trial.The archives of bone and joint surgery · 2026Article
- The Impact of Vitamin C on Analgesic, Anti-inflammatory, and Hemostatic Outcomes After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis.The archives of bone and joint surgery · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Homelessness affects over 550,000 individuals in the United States each night, with the number and average age of homeless individuals steadily rising. This population suffers from a higher prevalence of chronic diseases, increasing their vulnerability to adverse health outcomes. Total knee arthroplasty (TKA) is a frequently performed surgery in the United States and is typically successful; however, concerns about postoperative complications are heightened for homeless patients. This study aimed to compare complication rates between homeless and non-homeless patients undergoing TKA. Methods: A retrospective cohort study was conducted using the TriNetX Research Network database. Patients who underwent primary TKA were identified using CPT codes 27447, with homeless patients classified using ICD-9 and ICD-10 codes. A total of 245,567 patients were included, with 463 categorized as homeless. Demographic variables and postoperative complications were analyzed, and odds ratios (OR) were calculated for various outcomes, comparing homeless to non-homeless patients. Chi-square analysis and Fisher's exact test were used to determine statistical significance. Results: Homeless patients were more likely to be over 65, obese, diabetic, and smokers, all of which are risk factors for poor postoperative outcomes. Superficial surgical site infections (0.6 versus 0.1% p=0.008, OR 7.52; 95% CI: 2.40-23.63), prosthetic joint infections (2.2 versus 0.8% p=0.005, OR 2.70; 95% CI: 1.44-5.06), acute renal failure (4.5 versus 1.9% p<0.001, OR 2.44; 95% CI: 1.57-3.78), blood loss anemia (13.2 versus 6.1% p<0.001, OR 2.25; 95% CI: 1.72 -2.95), and pulmonary embolism (2.4 versus 0.9 p<0.003, OR 2.81; 95% CI: 1.54-5.12) occurred more frequently in homeless patients. Conclusion: Homeless patients undergoing TKA face significantly higher risks of postoperative complications compared to their non-homeless counterparts. These findings underscore the need for targeted preoperative optimization and tailored postoperative care to improve outcomes for this vulnerable population.
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