Literature DB >> 16133286

[Risk profiling of postoperative complications in 17,644 total knee replacements].

A Claus1, G Asche, J Brade, M Bosing-Schwenkglenks, H Horchler, J Müller-Färber, W Schumm, K Weise, H-P Scharf.   

Abstract

AIM: Postoperative complications following primary total knee replacement performed between 2000 and 2002 were assessed to determine perioperative patient- and procedure-related risks associated with the procedure.
METHODS: For this analysis, the data collected during postoperative hospitalization for 17,644 total knee arthroplasties were assessed. The analysis included two steps. First, using logistic regression, we identified and quantified significant risk factors for the occurrence of general postoperative complications. Second, univariate analysis was utilized to qualitatively and quantitatively analyze the influence of these significant risk factors on the occurrence of major complications (hematoma, cardiovascular complication, deep venous thrombosis, pulmonary embolism, joint infection, and pneumonia).
RESULTS: General postoperative complications were reported in 11.3%. Major postoperative complications occurred in 7.2% with hematoma in 2.9%, cardiovascular complications in 1.8%, deep venous thrombosis in 1.2%, pulmonary embolism in 0.2%, joint infection in 0.8%, and pneumonia in 0.3%. Patient-related risk factors such as age, surgery time, gender, high ASA classification as well as procedure-related risk factors such as allogeneic blood transfusions and lateral release significantly increased the rate of postoperative complications. Males were more prone to hematoma, joint infection, and pneumonia in the immediate postoperative course than females, who were more in danger of developing deep venous thrombosis. Allogeneic blood transfusions increased the risk for postoperative hematoma, infection, and cardiovascular complication. Regional anesthesia was shown to decrease the risk for the occurrence of postoperative deep venous thrombosis and pulmonary embolism.
CONCLUSIONS: Postoperative complications in total knee replacement are increased in males and elder patients. Increased time of surgery and allogeneic blood transfusions also represent important risk factors for postoperative complications following primary total knee replacement.

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Year:  2006        PMID: 16133286     DOI: 10.1007/s00113-005-0992-2

Source DB:  PubMed          Journal:  Unfallchirurg        ISSN: 0177-5537            Impact factor:   1.000


  10 in total

1.  The incidence of proximal deep vein thrombosis following total knee arthroplasty in an Asian population: a Doppler ultrasound study.

Authors:  S Nathan; Md A Aleem; P Thiagarajan; S Das De
Journal:  J Orthop Surg (Hong Kong)       Date:  2003-12       Impact factor: 1.118

2.  How safe is primary knee replacement surgery? Perioperative complication rates in Northern Illinois, 1993-1999.

Authors:  Joe Feinglass; Hagay Amir; Patricia Taylor; Ithai Lurie; Larry M Manheim; Rowland W Chang
Journal:  Arthritis Rheum       Date:  2004-02-15

Review 3.  Nonpharmacologic thromboembolic prophylaxis in total knee arthroplasty.

Authors:  F Bottner; T P Sculco
Journal:  Clin Orthop Relat Res       Date:  2001-11       Impact factor: 4.176

4.  Randomized trial of epidural versus general anesthesia: outcomes after primary total knee replacement.

Authors:  P Williams-Russo; N E Sharrock; S B Haas; J Insall; R E Windsor; R S Laskin; C S Ranawat; G Go; S B Ganz
Journal:  Clin Orthop Relat Res       Date:  1996-10       Impact factor: 4.176

5.  Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario.

Authors:  Hans J Kreder; Paul Grosso; Jack I Williams; Susan Jaglal; Tami Axcell; Eugene K Wal; David J G Stephen
Journal:  Can J Surg       Date:  2003-02       Impact factor: 2.089

6.  Incidence and risk factors for allogenic blood transfusion during major joint replacement using an integrated autotransfusion regimen. The Rizzoli Study Group on Orthopaedic Anaesthesia.

Authors:  B Borghi; A Casati
Journal:  Eur J Anaesthesiol       Date:  2000-07       Impact factor: 4.330

7.  Transfusion of buffy coat-depleted blood components and risk of postoperative infection in orthopedic patients.

Authors:  P Innerhofer; C Walleczek; G Luz; P Hobisch-Hagen; A Benzer; B Stöckl; G Hessenberger; W Nussbaumer; W Schobersberger
Journal:  Transfusion       Date:  1999-06       Impact factor: 3.157

8.  [Complications after total knee arthroplasty].

Authors:  R Steffen; R von Bremen-Kühne; Th Eppe
Journal:  Zentralbl Chir       Date:  2003-01       Impact factor: 0.942

9.  Provider Volume of Total Knee Arthroplasties and Patient Outcomes in the HCUP-Nationwide Inpatient Sample.

Authors:  Sheleika L Hervey; Harriett R Purves; Ulrich Guller; Alison P Toth; Thomas P Vail; Ricardo Pietrobon
Journal:  J Bone Joint Surg Am       Date:  2003-09       Impact factor: 5.284

10.  Effects of epidural anesthesia on incidence of venous thromboembolism following joint replacement.

Authors:  S B Haas
Journal:  Orthopedics       Date:  1994-07       Impact factor: 1.390

  10 in total
  3 in total

Review 1.  [Postoperative complications in trauma surgery].

Authors:  C Josten; C Schmidt
Journal:  Chirurg       Date:  2009-09       Impact factor: 0.955

2.  [Pain therapy using stimulating catheters after total knee arthroplasty].

Authors:  P Fritze; S Anderl; A Marouf; R Cumlivski; Ch Müller; E Pernicka; G Redl
Journal:  Schmerz       Date:  2009-06       Impact factor: 1.107

3.  Possible risk factors for acute and chronic deep periprosthetic joint infections in primary total knee arthroplasty. Do BMI, smoking, urinary tract infections, gender, and ASA classification have an impact?

Authors:  E Schiffner; D Latz; A Karbowski; J P Grassmann; S Thelen; S Gehrmann; J Windolf; J Schneppendahl; P Jungbluth
Journal:  J Orthop       Date:  2019-11-27
  3 in total

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