Thirty-day Postoperative Complications Following Primary Total Knee Arthroplasty: A Retrospective Study of Incidence and Risk Factors at a Single Center in China

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2017 Aug 25

PMID 28836570

Citations 11

Authors

Bin Feng

Jin Lin

Jin Jin

Wen-Wei Qian

Wei Wang

Xi-Sheng Weng

Affiliations

Soon will be listed here.

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.

Citing Articles

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Influence of Diabetes Mellitus on Postoperative Complications After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

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References

Thornqvist C, Gislason G, Kober L, Jensen P, Torp-Pedersen C, Andersson C . Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement. Acta Orthop. 2014; 85(5):456-62. PMC: 4164861. DOI: 10.3109/17453674.2014.934184. View

Galat D, McGovern S, Larson D, Harrington J, Hanssen A, Clarke H . Surgical treatment of early wound complications following primary total knee arthroplasty. J Bone Joint Surg Am. 2009; 91(1):48-54. DOI: 10.2106/JBJS.G.01371. View

Sutton 3rd J, Antoniou J, Epure L, Huk O, Zukor D, Bergeron S . Hospital Discharge within 2 Days Following Total Hip or Knee Arthroplasty Does Not Increase Major-Complication and Readmission Rates. J Bone Joint Surg Am. 2016; 98(17):1419-28. DOI: 10.2106/JBJS.15.01109. View

Labek G, Thaler M, Janda W, Agreiter M, Stockl B . Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg Br. 2011; 93(3):293-7. DOI: 10.1302/0301-620X.93B3.25467. View

Vorhies J, Wang Y, Herndon J, Maloney W, Huddleston J . Decreased length of stay after TKA is not associated with increased readmission rates in a national Medicare sample. Clin Orthop Relat Res. 2011; 470(1):166-71. PMC: 3237965. DOI: 10.1007/s11999-011-1957-0. View

Zmistowski B, Restrepo C, Hess J, Adibi D, Cangoz S, Parvizi J . Unplanned readmission after total joint arthroplasty: rates, reasons, and risk factors. J Bone Joint Surg Am. 2013; 95(20):1869-76. DOI: 10.2106/JBJS.L.00679. View

Rand J, Trousdale R, Ilstrup D, Harmsen W . Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am. 2003; 85(2):259-65. DOI: 10.2106/00004623-200302000-00012. View

Pulido L, Ghanem E, Joshi A, Purtill J, Parvizi J . Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008; 466(7):1710-5. PMC: 2505241. DOI: 10.1007/s11999-008-0209-4. View

Liu J, Elkassabany N, Poultsides L, Nelson C, Memtsoudis S . Staging Bilateral Total Knee Arthroplasty During the Same Hospitalization: The Impact of Timing. J Arthroplasty. 2015; 30(7):1172-6. DOI: 10.1016/j.arth.2015.02.006. View

10.

Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J . Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004; 86(5):963-74. DOI: 10.2106/00004623-200405000-00012. View

11.

McElroy M, Pivec R, Issa K, Harwin S, Mont M . The effects of obesity and morbid obesity on outcomes in TKA. J Knee Surg. 2013; 26(2):83-8. DOI: 10.1055/s-0033-1341407. View

12.

Gill G, Mills D, Joshi A . Mortality following primary total knee arthroplasty. J Bone Joint Surg Am. 2003; 85(3):432-5. DOI: 10.2106/00004623-200303000-00005. View

13.

Baker P, Cowling P, Kurtz S, Jameson S, Gregg P, Deehan D . Reason for revision influences early patient outcomes after aseptic knee revision. Clin Orthop Relat Res. 2012; 470(8):2244-52. PMC: 3392406. DOI: 10.1007/s11999-012-2278-7. View

14.

Suleiman L, Edelstein A, Thompson R, Alvi H, Kwasny M, Manning D . Perioperative Outcomes Following Unilateral Versus Bilateral Total Knee Arthroplasty. J Arthroplasty. 2015; 30(11):1927-30. DOI: 10.1016/j.arth.2015.05.039. View

15.

Hussain N, Chien T, Hussain F, Bookwala A, Simunovic N, Shetty V . Simultaneous versus staged bilateral total knee arthroplasty: a meta-analysis evaluating mortality, peri-operative complications and infection rates. HSS J. 2014; 9(1):50-9. PMC: 3640720. DOI: 10.1007/s11420-012-9315-7. View

16.

Feng B, Weng X, Lin J, Jin J, Wang W, Qiu G . Long-term follow-up of cemented fixed-bearing total knee arthroplasty in a Chinese population: a survival analysis of more than 10 years. J Arthroplasty. 2013; 28(10):1701-6. DOI: 10.1016/j.arth.2013.03.009. View

17.

Cram P, Lu X, Kaboli P, Vaughan-Sarrazin M, Cai X, Wolf B . Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991-2008. JAMA. 2011; 305(15):1560-7. PMC: 3108186. DOI: 10.1001/jama.2011.478. View

18.

Parvizi J, Smith E, Pulido L, Mamelak J, Morrison W, Purtill J . The rise in the incidence of pulmonary embolus after joint arthroplasty: is modern imaging to blame?. Clin Orthop Relat Res. 2007; 463:107-13. DOI: 10.1097/BLO.0b013e318145af41. View

19.

Kirksey M, Chiu Y, Ma Y, Gonzalez Della Valle A, Poultsides L, Gerner P . Trends in in-hospital major morbidity and mortality after total joint arthroplasty: United States 1998-2008. Anesth Analg. 2012; 115(2):321-7. DOI: 10.1213/ANE.0b013e31825b6824. View

20.

Parvizi J, Mui A, Purtill J, Sharkey P, Hozack W, Rothman R . Total joint arthroplasty: When do fatal or near-fatal complications occur?. J Bone Joint Surg Am. 2007; 89(1):27-32. DOI: 10.2106/JBJS.E.01443. View