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The Joint EBJIS-MSIS 2026 Conference
17 - 19 September, 2026 | Porto, Portugal
EP383
SSRI/SNRI Use Within 6 Months Prior to Primary TKA Increases Risk of Postoperative Infection and Complications: A Global Database Analysis
Part of Topic
Prosthetic Joint Infections
Introduction:
Selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs) are commonly used among patients undergoing primary total knee arthroplasty (TKA).
However, the association of preoperative SSRI/SNRI use on postoperative outcomes following TKA remains incompletely understood.
Aim: To evaluate whether SSRI/SNRI use within 6 months before surgery is associated with differences in short- and mid-term postoperative outcomes following primary unilateral TKA.
A retrospective cohort study using TriNetX Global Database (2010-2024).
Overall 18% (41,459/227,862) had a SSRI/SNRI use within 6 months prior to TKA.
After propensity score matching, preoperative SSRI/SNRI use was associated with increased 90-days odds of: PJI, emergency department (ED) visits, readmission, pulmonary embolism, transfusion, and wound dehiscence.
Superficial infection, deep vein thrombosis, hematoma, myocardial infarction, and delirium were not significantly different.
At 1-year, SSRI/SNRI use was associated with increased odds of PJI, revision, periprosthetic fracture, opioid prescription, and opioid dependence/abuse.
Same associations persisted at 2-years after surgery.
Conclusion:
Preoperative SSRI/SNRI use within 6 months of primary TKA was associated with higher rates of short-term complications and worse 1- and 2-year outcomes, including infection, even after matching for psychiatric comorbidities, opioid use, and other key patient factors.
SSRI/SNRI use may be an important preoperative risk marker for postoperative morbidity after TKA.