Normal Pressure Hydrocephalus Is Associated With Increased Risks of Postoperative Complications Following Total Knee and Total Hip Arthroplasty

Normal pressure hydrocephalus (NPH) has not been studied as a potential risk factor for postoperative complications after primary total knee (TKA) and total hip arthroplasty (THA).

Nearly 2000 patients with a diagnosis of NPH who underwent TKA or THA from 2005 to 2014 were identified in a national insurance database and compared to 10:1 matched controls using a logistic regression analysis.

NPH was associated with an increased risk of hospital readmission, emergency room visit, and infection following TKA (odds ratio 1.48-2.70, all P < .01). NPH was associated with an increased risk of hospital readmission, emergency room visit, and dislocation following THA (odds ratio 2.40-2.50, all P < .01). NPH was also associated with significantly higher costs and hospital length of stay following both procedures.

The diagnosis of NPH is associated with an elevated risk of postoperative complications and increased resource utilization following TKA and THA.