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Total shoulder arthroplasty in patients with factor V Leiden.

Title: Total shoulder arthroplasty in patients with factor V Leiden.
Authors: Zehner, Katie M.1 (AUTHOR); Sanchez, Joshua G.1 (AUTHOR); Dhodapkar, Meera M.1 (AUTHOR); Modrak, Maxwell1 (AUTHOR); Luo, Xuan1 (AUTHOR); Grauer, Jonathan N.1 (AUTHOR) jonathan.grauer@yale.edu
Source: Journal of Shoulder & Elbow Surgery. Jan2025, Vol. 34 Issue 1, p18-25. 8p.
Abstract: Anatomic and reverse total shoulder arthroplasty (TSA) are effective treatment options for end-stage glenohumeral osteoarthritis. However, consideration for pre-existing conditions must be taken into account. Factor V Leiden (FVL), the most common inherited thrombophilia, is one such condition that predisposes to a prothrombotic state and may affect perioperative and longer-term outcomes following TSA. Adult patients undergoing primary TSA for osteoarthritis indication were identified in the 2010 through October 2021 PearlDiver M157 database. Patients with or without FVL were matched at a 1:4 ratio based on age, sex, and Elixhauser Comorbidity Index. Ninety-day adverse events and 5-year revision rates were assessed and compared with multivariable logistic regression and rank-log tests, respectively. Finally, the relative use and bleeding/clotting outcomes were assessed based on venous thromboembolic (VTE) prophylactic agents used, with categories defined as (1) warfarin, heparin, or direct oral anticoagulant (DOAC) or (2) aspirin/no prescription found. Of 104,258 TSA patients, FVL was identified for 283 (0.27%). Based on matching, 1081 patients without FVL and 272 patients with FVL were selected. Multivariable analyses demonstrated that those with FVL displayed independently greater odds ratios (ORs) of deep vein thrombosis (DVT, OR = 9.50, P
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