Using a Tibial Short Extension Stem Reduces Tibial Component Loosening After Primary Total Knee Arthroplasty in Severely Varus Knees: Long-term Survival Analysis With Propensity Score Matching

2018 ◽  
Vol 33 (8) ◽  
pp. 2512-2517 ◽  
Author(s):  
Min-ho Park ◽  
Seong-Il Bin ◽  
Jong-Min Kim ◽  
Bum-Sik Lee ◽  
Chang-Rack Lee ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Survival Analysis ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Term Survival ◽  
Total Knee ◽  
Component Loosening ◽  
Primary Total Knee

Thromboembolic and bleeding complications following primary total knee arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1571-1577
Author(s):  
Astrid Blicher Schelde ◽  
Janne Petersen ◽  
Thomas Bo Jensen ◽  
Kirill Gromov ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Major Bleeding ◽  
Multivariable Analysis ◽  
Primary Total Knee Arthroplasty ◽  
Bleeding Complications ◽  
All Cause Mortality ◽  
Total Knee ◽  
Primary Total Knee

Aims The aim of this study is to compare the effectiveness and safety of thromboprophylactic treatments in patients undergoing primary total knee arthroplasty (TKA). Methods Using nationwide medical registries, we identified patients with a primary TKA performed in Denmark between 1 January 2013 and 31 December 2018 who received thromboprophylactic treatment. We examined the 90-day risk of venous thromboembolism (VTE), major bleeding, and all-cause mortality following surgery. We used a Cox regression model to compute hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome, pairwise comparing treatment with dalteparin or dabigatran with rivaroxaban as the reference. The HRs were both computed using a multivariable and a propensity score matched analysis. Results We identified 27,736 primary TKA patients who received thromboprophylactic treatment (rivaroxaban (n = 18,846); dalteparin (n = 5,767); dabigatran (n = 1,443); tinzaparin (n = 1,372); and enoxaparin (n = 308)). In the adjusted multivariable analysis and compared with rivaroxaban, treatment with dalteparin (HR 0.68 (95% CI 0.49 to 0.92)) or dabigatran (HR 0.31 (95% CI 0.13 to 0.70)) was associated with a decreased risk of VTE. No statistically significant differences were observed for major bleeding or all-cause mortality. The propensity score matched analysis yielded similar results. Conclusion Treatment with dalteparin or dabigatran was associated with a decreased 90-day risk of VTE following primary TKA surgery compared with treatment with rivaroxaban. Cite this article: Bone Joint J 2021;103-B(10):1571–1577.

Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis

2017 ◽  
Vol 32 (9) ◽  
pp. S113-S118 ◽  
Author(s):  
Alexander S. McLawhorn ◽  
Michael C. Fu ◽  
William W. Schairer ◽  
Peter K. Sculco ◽  
Catherine H. MacLean ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Inpatient Care ◽  
Primary Total Knee Arthroplasty ◽  
Post Discharge ◽  
Adjusted Analysis ◽  
Total Knee ◽  
Primary Total Knee

Manipulation under Anesthesia after Knee Arthroplasty Is Associated with Worse Long-Term Clinical Outcomes and Survivorship

2019 ◽  
Author(s):  
David A. Crawford ◽  
Joanne B. Adams ◽  
Michael J. Morris ◽  
Keith R. Berend ◽  
Adolph V. Lombardi
Keyword(s):  
Total Knee Arthroplasty ◽  
Relative Risk ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Long Term Outcomes ◽  
Manipulation Under Anesthesia ◽  
Total Knee ◽  
Primary Total Knee

AbstractThe literature is mixed on the long-term fate of knees that undergo manipulation under anesthesia (MUA). The purpose of this study is to evaluate the long-term outcomes and survivorship of patients who required a MUA after primary total knee arthroplasty (TKA) compared with a cohort of patients who did not undergo a MUA. Between 2003 and 2007, 2,193 patients (2,783 knees) underwent primary TKA with 2-year minimum follow-up; 182 knees (6.5%) had a MUA. Patients who had a manipulation were younger (p < 0.001) and had worse preoperative range of motion (ROM) (p < 0.001). Postoperative ROM, Knee Society clinical (KSC), functional, and pain (KSP) scores, revisions, and survivorship were compared between MUA and no MUA. Mean follow-up was 9.7 years. MUA patients had lower postoperative ROM (p < 0.001), change in ROM (p < 0.001), KSC (p < 0.001), KSP (p < 0.001), and change in KSP scores (0.013). Revisions occurred in 18 knees (9.9%) in the MUA group compared with 77 knees (3%) without a MUA (p < 0.001). Most common reason for revision after MUA was continued stiffness (50%). Relative risk for revision after one MUA was 2.01 (95% confidence interval [CI], 1.1–3.8, p < 0.001) and after three or more MUAs were 27.02 (95% CI, 16.5–44.1, p < 0.001). Ten-year survival after MUA was 89.4% (95% CI, 87.1–91.7%) compared with 97.2% (95% CI, 96.9–97.5%) without a MUA (p < 0.001). Patients who undergo a MUA after primary TKA may have a knee at risk with higher revision rates, worse long-term clinical scores, ROM and survivorship.

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