Weight and height separated provide better understanding than BMI on the risk of revision after total knee arthroplasty: report of 107,228 primary total knee arthroplasties from the Swedish Knee Arthroplasty Register 2009–2017

Sezgin, Erdem Aras; W‐Dahl, Annette; Lidgren, Lars; Robertsson, Otto

doi:10.1080/17453674.2019.1688006

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…First, the study period was 10 years, possible modifications of the perioperative care protocol and surgical techniques could have an impact on the rates of SSI and PJI events. Second, compared with several large-scale studies 17 – 20 , our rates of SSC (1.1%, N = 80) and PJI (0.2%, N = 16) in the early postoperative period were low. Despite the relatively large sample size of this study (N = 7511), the number of SSC and PJI events were small.…”

Section: Discussioncontrasting

confidence: 57%

“…Pharmacological VTE prophylaxis might lead to (1) postoperative hematoma, which acts as a nidus for bacteria to settle, and (2) prolonged wound drainage, which increases wound tension, bypasses the natural barrier of the skin, increases risk of wound dehiscence and provides a retrograde pathway for pathogens 8 , 11 , 16 , but whether the pharmacological agents for prophylaxis would increase the risk of infection following TJA procedures was inconsistent 7 . The rates of SSC were generally higher in studies with routine pharmacological VTE prophylaxis than those studies in which pharmacological VTE prophylaxis were not routinely administered (0.4–13.3% vs. 1.5–3.6%) 17 – 20 . The rates of PJI were similar between studies with or without routine pharmacological VTE prophylaxis (0.4–1.5% vs. 0.48–1.63%) 17 – 20 .…”

Section: Discussionmentioning

confidence: 86%

“…The rates of SSC were generally higher in studies with routine pharmacological VTE prophylaxis than those studies in which pharmacological VTE prophylaxis were not routinely administered (0.4–13.3% vs. 1.5–3.6%) 17 – 20 . The rates of PJI were similar between studies with or without routine pharmacological VTE prophylaxis (0.4–1.5% vs. 0.48–1.63%) 17 – 20 . However, the design of these studies were case series lacked a control group.…”

Section: Discussionmentioning

confidence: 86%

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Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty

Pai

Chang

Tsai

et al. 2022

Sci Rep

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Venous thromboembolism (VTE) prophylaxis has been suggested for patients who underwent total join arthroplasty (TJA). However, the morbidity of surgical site complications (SSC) and periprosthetic joint infection (PJI) has not been well evaluated. We aimed to evaluate the impact of VTE prophylaxis on the risk of early postoperative SSC and PJI in a Taiwanese population. We retrospectively reviewed 7511 patients who underwent primary TJA performed by a single surgeon from 2010 through 2019. We evaluated the rates of SSC and PJI in the early postoperative period (30-day, 90-day) as well as 1-year reoperations. Multivariate regression analysis was used to identify possible risk factors associated with SSC and PJI, including age, sex, WHO classification of weight status, smoking, diabetes mellitus (DM), rheumatoid arthritis(RA), Charlson comorbidity index (CCI), history of VTE, presence of varicose veins, total knee or hip arthroplasty procedure, unilateral or bilateral procedure, or receiving VTE prophylaxis or blood transfusion. The overall 90-day rates of SSC and PJI were 1.1% (N = 80) and 0.2% (N = 16). VTE prophylaxis was a risk factor for 90-day readmission for SSC (aOR: 1.753, 95% CI 1.081–2.842), 90-day readmission for PJI (aOR: 3.267, 95% CI 1.026–10.402) and all 90-day PJI events (aOR: 3.222, 95% CI 1.200–8.656). Other risk factors included DM, underweight, obesity, bilateral TJA procedure, younger age, male sex and RA. Pharmacological thromboprophylaxis appears to be a modifiable risk factor for SSC and PJI in the early postoperative period. The increased infection risk should be carefully weighed in patients who received pharmacological VTE prophylaxis.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 86%

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Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty

Pai

Chang

Tsai

et al. 2022

Sci Rep

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“…Several studies have shown an increased overall risk of revision after TKA in obese patients without looking at the specific reason for revision (Roche et al 2018, Tohidi et al 2018, Boyce et al 2019. However, a recent study showed that obesity was associated with overall risk of revision and revision for infection, but not for revision for reasons other than infection (Sezgin et al 2020).…”

mentioning

confidence: 99%

“…However, a recent study showed that obesity was associated with overall risk of revision and revision for infection, but not for revision for reasons other than infection (Sezgin et al. 2020 ).…”

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confidence: 99%

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

et al. 2020

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No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty

Pronk

Paters

Brinkman

2020

Knee Surg Sports Traumatol Arthrosc

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PurposeMedial unicompartmental knee arthroplasty (UKA) has excellent survival rates using one of the two implant designs: mobile bearing (MB) or fixed bearing (FB). There is a lack of studies comparing patient‐reported outcomes (PROs) of both implants. This study aimed to document and compare PROs of MB UKA to FB UKA at 6, 12 and 24 months after surgery. MethodsA single high‐volume surgeon, retrospective cohort study with prospectively collected data of two groups of UKA patients, with a MB (n = 66) or FB (n = 97) implant. Primary outcome was patient satisfaction (0–10; NRS). Secondary outcomes were pain at rest (NRS), pain during activity (NRS), function (OKS, KOOS‐PS), quality of life (EQ‐5D‐3L), anchor pain, anchor function and anchor recovery. PROs were collected 6, 12 and 24 months postoperatively. The complication rate and revision rate within one year after surgery were recorded. ResultsFor the MB group, the median NRS satisfaction score was 9.0 (8.0–10.0) compared to 9.0 (8.0–9.5) for the FB group at 6 months (p = 0.620). Similar scores were found at 12 and 24 months; both MB 9.0 (8.0–10.0) and FB 9.0 (8.0–10.0) (p = 0.556 and p = 0.522, respectively). There were no statistically significant differences between MB and FB groups in all secondary outcomes postoperatively. ConclusionMedial UKA performed by a high‐volume surgeon, using a MB or a FB implant, results in excellent patient satisfaction, pain relief, functional improvement and quality of life improvement at 6, 12 and 24 months after surgery. The recommendation and use of one over the other is not justified based on the outcomes in the current study. Level of evidenceIII.

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Weight and height separated provide better understanding than BMI on the risk of revision after total knee arthroplasty: report of 107,228 primary total knee arthroplasties from the Swedish Knee Arthroplasty Register 2009–2017

Cited by 14 publications

References 17 publications

Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty

Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty

Bariatric surgery prior to total knee arthroplasty is not associated with lower risk of revision: a register-based study of 441 patients

No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty

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