Thirty-day Postoperative Complications following Primary Total Knee Arthroplasty

Abstract

Background:Total knee arthroplasty (TKA) may be associated with serious complications that adversely affect outcomes and increase the likelihood of disability. However, few studies with sufficient sample size have reported postoperative complications following TKA among Chinese patients. This study aimed to evaluate complications of TKA within 30 postoperative days and to identify the related risk factors.Methods:A retrospective complication-based analysis of TKA using the arthroplasty registry between 2008 and 2013 was performed by summarizing complications of TKA within 30 postoperative days. Multivariate logistic regression was used to identify the predicting factors for complications 30 days after operation.Results:A total of 1542 patients underwent 2254 primary TKA between January 2008 and December 2013. A total of 137 complications occurred within 30 days after operation with an incidence rate of 6.1%. The incidence rate of major systemic complications within postoperative 30 days was 2.3%, with cardiovascular and respiratory complications as the most common complications. The incidence rates of deep venous thrombosis (DVT) and local complications were 2.4% and 1.0%, respectively. The 30-day postoperative mortality rate was 0.1% (3/2254). Multivariate logistic regression analyses identified body mass index (BMI) of ≥30.0 kg/m2 (odds ratio [OR]: 1.47) and age ≥80 years (OR: 1.87) as significant risk factors for postoperative systemic complications. A BMI of ≥30.0 kg/m2 was a significant risk factor for DVT (OR: 2.86) and other complications (OR: 2.11). The comorbidity of diabetes was a risk factor for postoperative mortality (OR: 19.20).Conclusions:This study highlighted complications with cardiac and respiratory origins as the most common complications within 30 postoperative days following primary TKA. The BMI of ≥30.0 kg/m2 and age ≥80 years were significant risk factors for 30-day postoperative complications.

Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults - a prospective observational study

“…Therefore, it is very important to find out the factors related to postoperative complications from cardiac surgery and to find corresponding prevention or treatment measures. Recently, postoperative outcome at 30 days has been widely recognized as an important early stage in postoperative recovery [8–10], especially for cardiac surgery [11–15]. Middle-aged and older people, who are more likely to be frail, have been reported to have inferior surgical outcomes [16, 17] and an elevated risk of postoperative complications [1].…”

Fatores associados ao desenvolvimento de complicações precoces após artroplastia total do joelho

“…Apesar dos pacientes classificados como ASA 3 ou superior apresentarem um maior risco de complicações, grande parte dos pacientes são classificados como ASA 2, diminuindo a relevância do escore, pois ele não contempla o número de comorbidades. Foi observado que o número de comorbidades aumentou o risco de complicações e este dado deve ser considerado na avaliação pré-operatória do paciente 1 6 7 8 14 Foi também observado que pacientes com maiores idades tendem a ter mais complicações, e estudos recentes evidenciam que com > 80 anos são de risco para a ocorrência de complicações. No entanto, a literatura sugere que a presença de comorbidades parece ser mais relevante do que a idade isoladamente.…”

“…Comorbidades clínicas, estimativas de tempo cirúrgico, idade e índice de massa corporal IMC também são avaliados. 4 7 8 9 No entanto, novos estudos podem melhorar a capacidade do cirurgião de identificar pacientes com maior risco de complicações pós-operatórias para que elas sejam manejadas adequadamente com o uso de diferentes técnicas e estratégias. 10…”

“…The medical comorbidities, estimates of surgical time, age, and body mass index (BMI) are also evaluated. 4 7 8 9 However, new studies may improve the ability of the surgeon to identify patients at higher risk of postoperative complications so that they are properly managed using different techniques and strategies. 10…”

Complications after Total Knee Arthroplasty

“…The incidence of wound problems after TKA is 1-25% [63]. The skin problems may be delayed wound healing, skin necrosis, traumatic or atraumatic separation of the lips of the wound, prolonged serous discharge at the wound site, formation of superficial or deep hematoma, allergic reaction to patch, suture material or dressing materials, bullae formation, fat necrosis, bleeding, keloid formation, and superficial or deep infection [64].…”