scholarly journals Risk factors for a post-operative neutrally aligned total knee arthroplasty in the sagittal plane developing fixed flexion deformity at 2 years follow up study

2019 ◽  
Vol 5 (2) ◽  
pp. 211 ◽  
Author(s):  
Amila Silva ◽  
Sharon Tan ◽  
Adriel Tay ◽  
Hee Nee Pang ◽  
Ngai Nung Lo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Sagittal Plane ◽  
P Value ◽  
Flexion Deformity ◽  
Maximum Flexion ◽  
Total Knee ◽  
Independent Risk Factors ◽  
Fixed Flexion Deformity

<p class="abstract"><strong>Background:</strong> The incidence of fixed flexion deformity (FFD) following total knee arthroplasty (TKA) has been reported to be as high as 17%, increasing demand on the quadriceps and hindering mobility. The aim of this study is then to identify these predictors for the development of FFD.</p><p class="abstract"><strong>Methods:</strong> In this retrospective study, all patients who underwent primary TKA from January 2008 to June 2009 at a single institution were identified. All patients with neutral alignment in the sagittal place of the knee intra-operatively were identified and followed up. The knee motion was measured in both operated and contralateral knees and followed-up for a minimum of 24 months post-operatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Multivariate analysis demonstrated pre-operative FFD of the non-operated knee (p-value 0.03), pre-operative range of motion of the operated knee (p-value 0.01) and non-operated (p-value 0.01) knee and pre-operative maximum flexion of the operated knee (p-value 0.001) to be independent risk factors for development of FFD at 24 months.</p><p class="abstract"><strong>Conclusions:</strong> Independent risk factors for the development of post-operative FFD in TKA are pre-operative FFD of the operated knee, FFD of the non-operated knee and the maximum flexion of the operated knee. The relative risk of a male developing FFD is also as high as 1.34.</p>

Fixed flexion deformity following total knee arthroplasty. A prospective study of the natural history

The Knee ◽  
2012 ◽  
Vol 19 (5) ◽  
pp. 519-521 ◽  
Author(s):  
Conal Quah ◽  
Girish Swamy ◽  
James Lewis ◽  
John Kendrew ◽  
Nitin Badhe
Keyword(s):  
Total Knee Arthroplasty ◽  
Natural History ◽  
Prospective Study ◽  
Knee Arthroplasty ◽  
Flexion Deformity ◽  
Total Knee ◽  
A Prospective Study ◽  
Fixed Flexion Deformity

scholarly journals Is Prevention of Postoperative Vomiting Surgery Dependent? A Retrospective Cohort Study of Total Knee Arthroplasty

2021 ◽  
Vol 11 (10) ◽  
pp. 1018
Author(s):  
Yan-Yuen Poon ◽  
Kuo-Chuan Hung ◽  
Wen-Yi Chou ◽  
Chih-Hsien Wang ◽  
Chao-Ting Hung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
General Anesthesia ◽  
Knee Arthroplasty ◽  
Study Endpoint ◽  
Clinical Settings ◽  
Postoperative Vomiting ◽  
Female Sex ◽  
Total Knee ◽  
Independent Risk Factors

The study of postoperative nausea and vomiting (PONV) has been ongoing since the early days of general anesthesia. The search for risk factors of PONV and the development of new agents to treat PONV are the two main strategies to combat the adverse side effects of general anesthesia. Female sex, non-smoking status, a history of PONV/motion sickness, and postoperative opioid use are the four independent risk factors for PONV derived after a series of prospective studies, evidence-based systematic reviews, and meta-analyses. The two frequently asked questions that arise ask whether risk factors apply to different clinical settings and whether prevention measures of PONV can be surgery dependent. We conducted a comprehensive review of 665 patients who underwent primary total knee arthroplasty (TKA) between January and December 2019. As nausea is subjective and its measurement is not standardized, postoperative vomiting (POV) was used as a study endpoint. The exclusion criteria were desflurane anesthesia, spinal anesthesia, anesthesia without bispectral index monitoring, and day surgery. Three well-recognized risk factors, consisting of body weight, sevoflurane consumption, and postoperative opioid consumption, were not considered as independent risk factors of POV, while female sex, preoperative adductor canal block (ACB), and dexamethasone were identified as being so in this study. The risk of POV in the female sex was 2.49 times that in the male sex; however, when dexamethasone was used, this risk was reduced by >40% compared with no antiemetic use, and by >50% when patients received preoperative ACB compared with those without the block. The clinical characteristics of our TKA patients—female dominance, old age, and their fairly constant body weights that were distinct from those of other surgical patients—suggested that age may play a crucial role in determining the relative contributions of the different risk factors of POV. We concluded that risk factors of POV are dependent on clinical settings. Based on these results, it is reasonable to speculate that a surgery-dependent plan for the prevention of POV is feasible for patients in similar clinical settings.

Total knee arthroplasty in patients with fixed flexion deformity

2013 ◽  
Vol 24 (6) ◽  
pp. 659-664 ◽  
Author(s):  
Jitesh Kumar Jain ◽  
Rajeev K. Sharma ◽  
Saurabh Agarwal
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Flexion Deformity ◽  
Total Knee ◽  
Fixed Flexion Deformity

Differences in the Risk Factors for Surgical Site Infection between Total Hip Arthroplasty and Total Knee Arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS)

2012 ◽  
Vol 33 (11) ◽  
pp. 1086-1093 ◽  
Author(s):  
Kyoung-Ho Song ◽  
Eu Suk Kim ◽  
Young Keun Kim ◽  
Hye Young Jin ◽  
Sun Young Jeong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Nosocomial Infections ◽  
Surveillance System ◽  
Total Knee ◽  
Independent Risk Factors ◽  
Incisional Ssis

Objective.To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.Design.Retrospective cohort study.Setting.Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).Patients.From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.Results.SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.Conclusions.Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.

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