Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

Whitlock, Keith; Piponov, Hristo; Shah, Sapan; Wang, Olivia J.; Gonzalez, Mark H.

doi:10.1016/j.arth.2016.05.041

Cited by 36 publications

(30 citation statements)

References 40 publications

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“…In cryotherapy applications, we think that this technique can affect a larger tissue area with the addition of a pad that allows constant cold application of the same temperature and is, thus, more effective for overweight patients. The prevelance of TKA in male patients is nearly 10 times lower than the females [24]. Also in our study, the percentage of males was nearly 10% (male: 10.1%, female: 89.9%).…”

Section: Discussionsupporting

confidence: 58%

Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

et al. 2019

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Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

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Section: Discussionsupporting

confidence: 58%

Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

et al. 2019

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“…There is no consensus on the contribution of sex to a prolonged LOS. Some researchers have found that females tend to have a longer LOS than males [6,11,27]. The authors explained that females are more likely to have higher rates of obesity, postoperative transfusion and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

Song

Xia

et al. 2020

BMC Musculoskelet Disord

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Background: Decreasing the length of hospital stay is an ideal course of action to appropriately allocate medical resources. The aim of this retrospective study was to identify perioperative factors that may decrease the length of hospital stay (LOS). Methods: In this study, we collected the data on 1112 patients who underwent primary total knee arthroplasty surgery (TKAs) at our institution from Jan 1, 2011 to Nov 31, 2017. Based on the published literature, 16 potential factors (12 preoperative variables, 1 intraoperative variable, and 3 postoperative variables) were investigated. The patients requiring a hospital stay longer than the mean LOS (8 days) were defined as patients with a prolonged LOS. The factors with a P value less than 0.1 in the univariate analysis were further analysed in a multivariate model. An ordinal regression was used to determine independent risk factors for a prolonged LOS. Results: The mean LOS was 8.3 days (±4.3), with a range of 2 to 30 days. Sixteen variables were analysed by univariate analysis, and 11 of them had p < 0.1 and were included in the multivariable model. Finally, 9 factors were found to be associated with a prolonged LOS. Among the 9 variables, 2 were surgery-related factors (operative time and intraoperative blood loss), and 3 were patient-related factors (age, ASA classification and neurological comorbidities). Conclusion: In this study, we found that the clinical protocol, complications, the patient's age, the ASA classification, neurological comorbidities, the operative time, the ward, intraoperative blood loss and the surgeon were all factors contributing to a prolonged LOS. In clinical practice, these factors provide important information for the surgeon and are useful for identifying patients with a high risk of a prolonged LOS.

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“…Preoperative fKSS was inversely related to successful 5-year postoperative fKSS outcome, which was earlier described for a 2-year follow-up period [33], and women had a worse outcome than men after a rTKA. This might be because women have higher rates of obesity even morbid obesity, postoperative transfusion, and extended length of stay, all of which are correlated with poor functional and clinical outcomes [34]. However, in a small retrospective study, no differences in gender were found [27].…”

Section: Discussionmentioning

confidence: 99%

Age, gender, functional KSS, reason for revision and type of bone defect predict functional outcome 5 years after revision total knee arthroplasty: a multivariable prediction model

Verbeek

Hannink

Defoort

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The number of revision total knee arthroplasties (rTKA) is increasing. Unfortunately, not all patients benefit from revision surgery. The aim of this study was to develop a clinical prediction model that can be used to predict the functional outcome 5 years after rTKA. Methods Data of patients receiving rTKA at Sint Maartenskliniek, Nijmegen, The Netherlands, from 2004 onwards were prospectively collected. Demographic and clinical variables and patient-reported outcome scores were collected and considered as potential predictors. Beneficial outcome was defined as an increase of ≥ 20 points on the functional knee society scores (fKSS) or an absolute fKSS ≥ 80 points 5 years after surgery. The prediction model was developed using backward logistic regression. Regression coefficients were converted into an easy to use prediction rule. Results Overall, 295 rTKA patients were included of whom 157 (53%) had beneficial fKSS 5 years later. Age, gender, femoral bone defects, preoperative fKSS, and stiffness as reason for revision were included in the model. Men had a higher chance of beneficial fKSS than women (OR 1.59, 95% CI 0.91–2.78). Patients with major bone defects (OR 0.44, 95% CI 0.22–0.85), higher age (IQR OR 0.39, 95% CI 0.26–0.58), higher preoperative fKSS (IQR OR 0.42, 95% CI 0.30–0.59), and severe stiffness (OR 0.48, 95% CI 0.20–1.15) had a lower chance of successful outcome. The model’s AUC was 0.76, 95% CI 0.70–0.81. Conclusion Easily determinable characteristics of patients who need rTKA can be used to predict future functional outcome. Young men with low preoperative fKSS without severe stiffness are more likely to achieve a beneficial outcome. Level of evidence IV.

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Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients

Cited by 36 publications

References 40 publications

Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

Age, gender, functional KSS, reason for revision and type of bone defect predict functional outcome 5 years after revision total knee arthroplasty: a multivariable prediction model

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