Impact of Benign Prostatic Hyperplasia on Postoperative Complications and Periprosthetic Joint Infections After Total Joint Arthroplasty: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Total joint arthroplasty (TJA) is one of the most frequently performed surgical procedures each year, offering considerable cost-effectiveness and numerous benefits. However, certain postoperative complications can be observed following TJA. While the relationship between various comorbidities and these complications has been well-documented, this study aims to specifically investigate the impact of benign prostatic hyperplasia (BPH) on postoperative outcomes. Methods: For this systematic review, we searched PubMed, Scopus, and Web of Science using terms like "total hip arthroplasty," "total knee arthroplasty," "BPH," and "benign prostatic hypertrophy." Screening of retrieved articles was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing complications in TJA between patients with and without preexisting BPH were eligible for inclusion. Data extraction was performed on the included articles, and their quality was assessed using the Newcastle-Ottawa scale. A meta-analysis was conducted using the Mantel-Haenszel method. Results: This systematic review encompassed 4 articles evaluating TJA outcomes in men with a history of BPH, involving a total of 75,222 male cases. Among these, 17,183 cases (23%) presented with symptomatic BPH. The meta-analysis revealed that the incidence rate of periprosthetic joint infection did not significantly differ between BPH and non-BPH groups across both total hip and knee arthroplasty cases (odds ratio [OR] (95% confidence interval [CI]) = 1.28 [0.92-1.79]). However, postoperative urinary retention was significantly higher among patients with BPH (OR [95% CI] = 3.43 [2.04-5.78]). Additionally, patients with BPH exhibited a notably elevated incidence of postoperative urinary tract infection (OR [95% CI] = 2.55 [2.33-2.79]), as well as sepsis (OR [95% CI] = 1.31 [1.09-1.58]). Conclusions: It is noteworthy that while patients with BPH are prone to certain complications, meta-analysis indicate that BPH cannot be considered a comorbidity that increases the risk of periprosthetic joint infection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.030 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.041 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".