Factors Associated with the Development of Early Complications after Total Knee Arthroplasty

Abstract

Objective To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty

Methods The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention.

Results Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications.

Conclusions Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Keywords

arthroplasty - arthroplasty, replacement, knee - comorbidities - complications - knee

Work developed at the Hospital Manoel Victorino, Salvador, Bahia, Brazil.

Publication History

Received: 23 August 2020

Accepted: 13 May 2021

Article published online:
28 October 2021

• Referências

• 1 Sarpong NO, Boddapati V, Herndon CL, Shah RP, Cooper HJ, Geller JA. Trends in Length of Stay and 30-Day Complications After Total Knee Arthroplasty: An Analysis From 2006 to 2016. J Arthroplasty 2019; 34 (08) 1575-1580
• 2 Wagner ER, Kamath AF, Fruth K, Harmsen WS, Berry DJ. Effect of Body Mass Index on Reoperation and Complications After Total Knee Arthroplasty. J Bone Joint Surg Am 2016; 98 (24) 2052-2060
• 3 Cheuy VA, Foran JRH, Paxton RJ, Bade MJ, Zeni JA, Stevens-Lapsley JE. Arthrofibrosis Associated With Total Knee Arthroplasty. J Arthroplasty 2017; 32 (08) 2604-2611
• 4 Frosch P, Decking J, Theis C, Drees P, Schoellner C, Eckardt A. Complications after total knee arthroplasty: a comprehensive report. Acta Orthop Belg 2004; 70 (06) 565-569
• 5 Pecora JR, Lima ALM, Helito CP, Gobbi RG, Demange MK, Camanho GL. Protocol for treating acute infections in cases of total knee arthroplasty. Acta Ortop Bras 2019; 27 (01) 27-30
• 6 Lehtonen EJ, Hess MC, McGwin Jr G, Shah A, Godoy-Santos AL, Naranje S. Risk factors for early hospital readmission following total knee arthroplasty. Acta Ortop Bras 2018; 26 (05) 309-313
• 7 Basques BA, Bell JA, Fillingham YA, Khan JM, Della Valle CJ. Gender Differences for Hip and Knee Arthroplasty: Complications and Healthcare Utilization. J Arthroplasty 2019; 34 (08) 1593-1597.e1
• 8 Feng B, Lin J, Jin J, Qian WW, Wang W, Weng XS. Thirty-day Postoperative Complications following Primary Total Knee Arthroplasty: A Retrospective Study of Incidence and Risk Factors at a Single Center in China. Chin Med J (Engl) 2017; 130 (21) 2551-2556
• 9 George J, Piuzzi NS, Ng M, Sodhi N, Khlopas AA, Mont MA. Association Between Body Mass Index and Thirty-Day Complications After Total Knee Arthroplasty. J Arthroplasty 2018; 33 (03) 865-871
• 10 Souza GGA, Ramalho RSC, Albuquerque RSPE, Barretto JM, Chaves RSM, de Sousa EB. Higher risk of complications after total knee arthroplasty in octogenarians. Acta Ortop Bras 2020; 28 (04) 177-181
• 11 Saklad MMD. Grading of Patients for Surgical Procedures. Anesthesiol J Am Soc Anesthesiol 1941; 2 (03) 281-284
• 12 Petersson IF, Boegård T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis 1997; 56 (08) 493-496
• 13 Thompson R, Novikov D, Cizmic Z. et al. Arthrofibrosis After Total Knee Arthroplasty: Pathophysiology, Diagnosis, and Management. Orthop Clin North Am 2019; 50 (03) 269-279
• 14 George J, Mahmood B, Sultan AA. et al. How Fast Should a Total Knee Arthroplasty Be Performed? An Analysis of 140,199 Surgeries. J Arthroplasty 2018; 33 (08) 2616-2622
• 15 Pugely AJ, Callaghan JJ, Martin CT, Cram P, Gao Y. Incidence of and risk factors for 30-day readmission following elective primary total joint arthroplasty: analysis from the ACS-NSQIP. J Arthroplasty 2013; 28 (09) 1499-1504
• 16 Helito CP, Sobrado MF, Giglio PN. et al. The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention. BMC Musculoskelet Disord 2020; 21 (01) 490
• 17 Arshi A, Leong NL, D'Oro A. et al. Outpatient Total Knee Arthroplasty Is Associated with Higher Risk of Perioperative Complications. J Bone Joint Surg Am 2017; 99 (23) 1978-1986
• 18 Bordoni V, Poggi A, Zaffagnini S, Previtali D, Filardo G, Candrian C. Outpatient total knee arthroplasty leads to a higher number of complications: a meta-analysis. J Orthop Surg Res 2020; 15 (01) 408
• 19 Crawford DA, Adams JB, Berend KR, Lombardi Jr AV. Low complication rates in outpatient total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2020; 28 (05) 1458-1464