No increased risk of postoperative adverse events in patients with hidradenitis suppurativa following a total joint replacement

There is concern for increased risk of adverse events, particularly periprosthetic joint infection (PJI), following total joint replacement (TJR) in patients with hidradenitis suppurativa (HS) because of a compromised skin barrier and bacterial colonization of lesions. We used the TriNetX health research database to identify patients who had undergone TJR with (n=1760) and without (n=1760) HS matched by age, sex, ethnicity, race and risk factors for PJI. Multivariate analysis was performed and revealed that 90-day risk of PJI, reoperation, wound dehiscence, delayed wound healing, emergency room visits and readmission were not increased among patients with HS who underwent TJR. Given these findings, dermatologists and orthopaedists should not defer TJR access for patients with HS, as risk of postoperative complications is not prohibitive.