scholarly journals Incidence and Risk Factors of In‐Hospital Prosthesis‐Related Complications Following Total Knee Arthroplasty: A Retrospective Nationwide Inpatient Sample Database Study

2021 ◽  
Author(s):  
Qin‐feng Yang ◽  
Ze‐ming Lin ◽  
Sheng Yang ◽  
Pin‐kai Wang ◽  
Rong Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Nationwide Inpatient Sample ◽  
Database Study ◽  
Nationwide Inpatient Sample Database ◽  
Total Knee

scholarly journals Incidence and Risk Factors of Postoperative Delirium Following Total Knee Arthroplasty: A Retrospective Nationwide Inpatient Sample Database Study

2020 ◽  
Author(s):  
Jian Wang ◽  
Qinfeng Yang ◽  
Yichuan Xu ◽  
Yuhang Chen ◽  
Qiang Lian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Total Knee Arthroplasty ◽  
Hospital Mortality ◽  
Knee Arthroplasty ◽  
Nationwide Inpatient Sample ◽  
Postoperative Delirium ◽  
Perioperative Complications ◽  
Total Knee ◽  
Total Charges

Abstract BackgroundPostoperative delirium is a common complication following major surgeries, causing a variety of adverse effects. However, the incidence and risk factors of delirium after total knee arthroplasty (TKA) has not been well studied using a large-scale national database. MethodsA retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2005-2014. Patients who underwent TKA were included. Patient demographics, comorbidities, length of stay (LOS), total charges, type of insurance, in-hospital mortality, and medical and surgical perioperative complications were evaluated.ResultsA total of 1,228,879 TKAs were obtained from the NIS database. The general incidence of delirium after TKA was 1.00%, which peaked in the year 2008. Patients with delirium after TKA presented more comorbidities, increased LOS, extra hospital charges, wider coverage of medicare, and higher in-hospital mortality (P<0.0001). Delirium following TKA was associated with medical complications during hospitalization including acute renal failure, acute myocardial infarction, pneumonia, pulmonary embolism, stroke, and urinary tract infection. Risk factors of postoperative delirium included advanced age, neurological disorders, alcohol and drug abuse, depression, psychoses, fluid and electrolyte disorders, diabetes, weight loss, deficiency and chronic blood loss anemia, coagulopathy, congestive heart failure, chronic pulmonary disease and pulmonary circulation disorders, peripheral vascular disorders, renal failure, and teaching hospital. ConclusionsA relatively low incidence of delirium after TKA was identified. Postoperative delirium of TKA was associated with increased comorbidities, LOS, total charges, coverage of medicare, mortality and medical perioperative complications. It is of benefit to study risk factors of postoperative delirium to ensure the appropriate management and moderate its consequences.

Risk Factors for Manipulation After Total Knee Arthroplasty: A Pooled Electronic Health Record Database Study

2014 ◽  
Vol 29 (10) ◽  
pp. 2036-2038 ◽  
Author(s):  
Kiel J. Pfefferle ◽  
Scott T. Shemory ◽  
Matthew F. Dilisio ◽  
Stephen D. Fening ◽  
Ian M. Gradisar
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Electronic Health Record ◽  
Knee Arthroplasty ◽  
Health Record ◽  
Database Study ◽  
Total Knee ◽  
Electronic Health

scholarly journals The Analysis of Risk Factors in No Thumb Test in Total Knee Arthroplasty

2011 ◽  
Vol 3 (4) ◽  
pp. 274 ◽  
Author(s):  
Jee Hyoung Kim ◽  
Song Lee ◽  
Dong Oh Ko ◽  
Chang Wook Yoo ◽  
Tae Hwan Chun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Wound Issues after Total Knee Arthroplasty

2015 ◽  
Vol 5 (1) ◽  
pp. 10-13
Author(s):  
Douglas A Dennis
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Soft Tissues ◽  
Wound Complications ◽  
Operative Techniques ◽  
Proper Selection ◽  
Wound Healing Problems ◽  
Total Knee ◽  
Selection Of

ABSTRACT Wound healing problems following total knee arthroplasty (TKA) are infrequent, but if present may lead to devastating results. Occurrence may be minimized by modifying patient risk factors, proper selection of skin incisions, and using operative techniques that protect soft tissues. When wound complications arise, prompt management is imperative to assure the best outcome after TKA. Jennings JM, Dennis DA. Wound Issues after Total Knee Arthroplasty. The Duke Orthop J 2015;5(1):10-13.

Reliable outcomes and survivorship of primary total knee arthroplasty for osteonecrosis of the knee

2019 ◽  
Vol 101-B (11) ◽  
pp. 1356-1361 ◽  
Author(s):  
Brian P. Chalmers ◽  
Kapil G. Mehrotra ◽  
Rafael J. Sierra ◽  
Mark W. Pagnano ◽  
Michael J. Taunton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Cox Regression Analysis ◽  
Primary Tkas ◽  
Total Knee ◽  
The Mean

Aims Knee osteonecrosis in advanced stages may lead to joint degeneration. Total knee arthroplasty (TKA) for osteonecrosis has traditionally been associated with suboptimal results. We analyzed outcomes of contemporary TKAs for osteonecrosis, with particular emphasis on: survivorship free from aseptic loosening, any revision, and any reoperation plus the clinical outcomes, complications, and radiological results. Patients and Methods In total, 156 patients undergoing 167 primary TKAs performed for osteonecrosis between 2004 and 2014 at a single institution were reviewed. The mean age at index TKA was 61 years (14 to 93) and the mean body mass index (BMI) was 30 kg/m2 (18 to 51) The mean follow-up was six years (2 to 12). A total of 110 TKAs (66%) were performed for primary osteonecrosis and 57 TKAs (34%) for secondary osteonecrosis. Overall, 15 TKAs (9%) had tibial stems, while 12 TKAs (7%) had femoral stems. Posterior-stabilized designs were used in 147 TKAs (88%) of TKAs. Bivariate Cox regression analysis was conducted to identify risk factors for revision and reoperation. Results Survivorship free from aseptic loosening, any revision, and any reoperation at ten years was 97% (95% confidence interval (CI) 93 to 100), 93% (95% CI 85 to 100), and 82% (95% CI 69 to 93), respectively. No factors, including age, sex, BMI, primary versus secondary osteonecrosis, stem utilization, and constraint, were identified as risk factors for reoperation. Four TKAs (2%) underwent revision, most commonly for tibial aseptic loosening (n = 2). Excluding revisions and reoperations, there was a total of 11 complications (7%), with the most common being a manipulation under anaesthesia (six TKAs, 4%). Mean Knee Society Scores (Knee component) significantly improved from 57 (32 to 87) preoperatively to 91 (49 to 100) postoperatively (p < 0.001). No unrevised TKAs had complete radiolucent lines or radiological evidence of loosening. Conclusion Contemporary cemented TKAs with selective stem utilization for osteonecrosis resulted in durable survivorship, a low complication rate, and reliable improvement in clinical outcomes. Cite this article: Bone Joint J 2019;101-B:1356–1361.

Decreasing Incidence of Postoperative Ileus following Total Knee Arthroplasty: A 17-Year Retrospective Review of 38,007 Knee Replacements at One Institution

2019 ◽  
Vol 33 (08) ◽  
pp. 750-753
Author(s):  
Bob H. Nguyen ◽  
Olivia J. Bono ◽  
James V. Bono
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Ileus ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty ◽  
Fiscal Year ◽  
Knee Replacements ◽  
Total Knee ◽  
Preventable Complication

AbstractIleus following total knee arthroplasty is a clinically and financially significant postoperative complication that has not been extensively described in the orthopaedic joint literature. Ileus has been found to occur in 0.7 to 4.0% of patients after total joint arthroplasty. In a 17-year period (2001 fiscal year through 2017 fiscal year) at one institution, we found an incidence of 0.500% (190/38,007) following knee arthroplasty. In addition, the incidence of ileus following total knee arthroplasty (TKA) has drastically declined over this 17-year period, from 1.593% (13/816) in 2001 to 0.120% (4/3,332) in 2017. This decrease may be attributed to a reduction in narcotic use postoperatively, earlier ambulation following surgery, and reduction in length of hospital stay. Though postoperative ileus is not yet a preventable complication, recognition of risk factors may permit earlier intervention to ameliorate some of the morbidity associated with this condition.

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