SynthesisArchives of orthopaedic and trauma surgery2026
Outcomes of modern total joint arthroplasty in patients with dementia: a systematic review of challenges and considerations for perioperative care.
Synthesis in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Long-Term Cognitive and Functional Outcomes of Anesthesia and Surgery in Patients with Dementia.Healthcare (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs the global prevalence of dementia rises, an increasing number of patients with cognitive impairment require Total Joint Arthroplasty (TJA). However, the specific impact of dementia on postoperative outcomes remains underreported. This systematic review evaluates the complications, mortality, and healthcare utilization associated with dementia in patients undergoing Total Hip (THA) and Total Knee Arthroplasty (TKA).
methodsA systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library was conducted following PRISMA guidelines. Eligible studies included comparative cohorts of patients with and without a diagnosis of dementia undergoing primary TJA. Methodological quality was appraised using the Newcastle-Ottawa Scale (NOS). Data were synthesized regarding mortality, readmissions, implant-related complications, and discharge disposition.
resultsSeven retrospective cohort studies comprising 13,816 patients with dementia and 869,061 controls were included. The mean NOS score was 8.4/9, indicating high methodological quality. Patients with dementia exhibited significantly worse outcomes across both procedures, including higher rates of postoperative delirium (OR: 4.25–6.40), mortality (HR: 1.43–3.05), and discharge to skilled nursing facilities (OR: 1.87). Stratification by procedure revealed distinct risk profiles: while both cohorts faced high readmission rates, THA patients demonstrated specific vulnerability to mechanical complications, including increased risks of dislocation, periprosthetic fracture (OR: 2.07), and revision surgery. These mechanical failures were frequently driven by falls and poor compliance with postoperative precautions rather than infection alone.
conclusionDementia is a robust independent predictor of adverse outcomes after TJA. While both THA and TKA carry elevated systemic risks, THA poses unique mechanical challenges that may warrant the use of high-stability implants (e.g., dual-mobility cups) to mitigate dislocation risks. Perioperative strategies should prioritize caregiver-led surveillance and strict fall prevention protocols to improve safety in this vulnerable population.
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