scholarly journals Long-Term Incidence of Total Knee Arthroplasty after Open Reduction and Internal Fixation of Proximal Tibial and Distal Femoral Fractures: A Nationwide Cohort Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5685
Author(s):  
Kuang-Ting Yeh ◽  
Wen-Tien Wu ◽  
Ru-Ping Lee ◽  
Chen-Chie Wang ◽  
Jen-Hung Wang ◽  
...  

Knee fractures often require open reduction internal fixation (ORIF) for knee function recovery. More than one fifth of patients with knee fractures subsequently develop posttraumatic arthritis, and over 5% of them need total knee arthroplasty (TKA). We conducted this nationwide retrospective cohort study using the data of 2,000,000 people in the general population who received TKA and were followed up in the 17-year period 2001–2017, through random sampling of the Taiwan National Health Insurance Research Database. We matched the ORIF and non-fracture groups by a propensity score, based on age, sex, index date of surgery, and comorbidities enrolled in CCI calculated at a 1:1 ratio. The average proportion of subjects receiving TKA after ORIF for distal femoral or proximal tibial fractures was 2.0 per 1000 person-years, which was significantly higher than that in the non-fracture group. Patients aged 20–65 years and males represented a significantly higher proportion of subjects receiving TKA after ORIF than that in the non-fracture group. The proportion of subjects receiving TKA for the 20–65-year subgroup of the ORIF group was 4%, and that for the male subgroup was 1.5%; both rates increased over the 17-year follow-up period. More aggressive intraoperative and postoperative adjuvant therapies may be necessary for these subgroups.

2001 ◽  
Vol 83 (8) ◽  
pp. 1144-1148 ◽  
Author(s):  
Khaled J. Saleh ◽  
Pamela Sherman ◽  
Pam Katkin ◽  
Russell Windsor ◽  
Stephen Haas ◽  
...  

2002 ◽  
Vol 84 (3) ◽  
pp. 498-500
Author(s):  
Khaled J. Saleh ◽  
Pamela Sherman ◽  
Pam Katkin ◽  
Russell Windsor ◽  
Stephen Haas ◽  
...  

2021 ◽  
Vol 3 (1) ◽  
pp. e000072
Author(s):  
Tosan Okoro ◽  
Sebastian Tomescu ◽  
J Michael Paterson ◽  
Bheeshma Ravi

ObjectivesThis study aimed to identify a threshold in annual surgeon volume associated with increased risk of revision (for any cause) and deep infection requiring surgery following primary elective total knee arthroplasty (TKA).DesignA propensity score matched cohort study.SettingOntario, Canada.Participants169 713 persons who received a primary TKA between 2002 and 2016, with 3-year postoperative follow-up.Main outcome measuresRevision arthroplasty (for any cause), and the occurrence of deep surgical infection requiring surgery.ResultsBased on restricted cubic spline analysis, the threshold for increased probability of revision and deep infection requiring surgery was <70 cases/year. After matching of 51 658 TKA recipients from surgeons performing <70 cases/year to TKA recipients from surgeons with greater than 70 cases/year, patients in the former group had a higher rate of revision (for any cause, 2.23% (95% Confidence Interval (CI) 1.39 to 3.07) vs 1.70% (95% CI 0.85 to 2.55); Hazard Ratio (HR) 1.33, 95% CI 1.21 to 1.47, p<0.0001) and deep infection requiring surgery (1.29% (95% CI 0.44 to 2.14) vs 1.09% (95% CI 0.24 to 1.94); HR 1.33, 95% CI 1.17 to 1.51, p<0.0001).ConclusionsFor primary TKA recipients, cases performed by surgeons who had performed fewer than 70 TKAs in the year prior to the index TKA were at 31% increased relative risk of revision (for any cause), and 18% increased relative risk for deep surgical infection requiring surgery, at 3-year follow-up.


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