Yoshinori Ishii1, Hideo Noguchi1, Junko Sato1, Hana Ishii2, Ryo Ishii3, Shin-Ichi Toyabe4. 1. Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan. 2. Kanazawa Medical University, School of Plastic Surgery, 1-1 Daigaku Uchinada, Ishikawa, 920-0253, Japan. 3. Sado General Hospital, 161 Chikusa Sado, Niigata, 952-1209, Japan. 4. Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan.
Abstract
BACKGROUND: Prolonged operative time has frequently been implicated as a risk factor for various complications after total knee arthroplasty (TKA). We aimed to determine whether preoperative factors such as sex, age, body mass index (BMI), prosthetic design, tibiofemoral angle (TFA), range of motion, coronal laxity, Hospital for Special Surgery score and periarticular bone mineral density (BMD) affect operative time. METHODS: We evaluated 164 patients (187 knees) with medial osteoarthritis who underwent primary TKA performed by a single surgeon. The medical records of 27 males and 137 females (median age of 77 and 72 years, respectively) were retrospectively reviewed. TFA was measured on non-weightbearing, standard radiographs. We used dual-energy X-ray absorptiometry to measure BMD, and an arthrometer to evaluate total coronal laxity in each patient. RESULTS: According to univariate analyses, there was a weak positive correlation between BMI and operative time (r = 0.265, p < 0.001), between TFA and operative time (r = 0.235, p = 0.001) and between BMD of the femur and tibia and operative time (r = 0.280, p < 0.001, r = 0.286, p < 0.001, respectively). No significant correlations were found between the other factors and operative time. Based on multivariate analyses, only BMD of the tibia and TFA were significantly correlated with operative time (β = 0.418, p < 0.001 and β = 0.182, p = 0.007, respectively). CONCLUSIONS: TFA and BMD of the tibia were the variables more strongly correlated with operative time. Surgeons should recognize preoperatively that patients who have increased TFA, higher periarticular BMD, and higher BMI may have longer operative times. LEVEL OF EVIDENCE: Level IV retrospective study.
BACKGROUND: Prolonged operative time has frequently been implicated as a risk factor for various complications after total knee arthroplasty (TKA). We aimed to determine whether preoperative factors such as sex, age, body mass index (BMI), prosthetic design, tibiofemoral angle (TFA), range of motion, coronal laxity, Hospital for Special Surgery score and periarticular bone mineral density (BMD) affect operative time. METHODS: We evaluated 164 patients (187 knees) with medial osteoarthritis who underwent primary TKA performed by a single surgeon. The medical records of 27 males and 137 females (median age of 77 and 72 years, respectively) were retrospectively reviewed. TFA was measured on non-weightbearing, standard radiographs. We used dual-energy X-ray absorptiometry to measure BMD, and an arthrometer to evaluate total coronal laxity in each patient. RESULTS: According to univariate analyses, there was a weak positive correlation between BMI and operative time (r = 0.265, p < 0.001), between TFA and operative time (r = 0.235, p = 0.001) and between BMD of the femur and tibia and operative time (r = 0.280, p < 0.001, r = 0.286, p < 0.001, respectively). No significant correlations were found between the other factors and operative time. Based on multivariate analyses, only BMD of the tibia and TFA were significantly correlated with operative time (β = 0.418, p < 0.001 and β = 0.182, p = 0.007, respectively). CONCLUSIONS: TFA and BMD of the tibia were the variables more strongly correlated with operative time. Surgeons should recognize preoperatively that patients who have increased TFA, higher periarticular BMD, and higher BMI may have longer operative times. LEVEL OF EVIDENCE: Level IV retrospective study.
Authors: Grace H Lo; Mehveen G Merchant; Jeffrey B Driban; Jeffrey Duryea; Lori Lyn Price; Charles B Eaton; Timothy E McAlindon Journal: Arthritis Rheumatol Date: 2018-01-09 Impact factor: 10.995
Authors: Terese T Horlocker; James R Hebl; Bhargavi Gali; Christopher J Jankowski; Christopher M Burkle; Daniel J Berry; Fernando A Zepeda; Susanna R Stevens; Darrell R Schroeder Journal: Anesth Analg Date: 2006-03 Impact factor: 5.108