This article is more than 5 years old. Information may no longer be current.

Longer surgery among post-TKA complication risk factors

Allogeneic blood transfusion and advanced patient age were also deemed high risk factors

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

A study of 17,644 total knee arthroplasties resulted in the identification of a host of risk factors that contribute sharply to increased rates of postoperative complications, including hematoma and deep venous thrombosis.

The researchers, from Mannheim, Germany, used a standardized protocol to document the major complications occurring during the postoperative hospitalization period, including hematoma, cardiovascular problems, deep venous thrombosis, pulmonary embolism, joint infection and pneumonia, said Alexandra M. Claus, MD. High classification according to the American Association of Anesthesiologists and lateral release also raised the rate of complications, she said.

�Using logistic regression, [we assessed] the influence of potential risk factors for their significance on postoperative complications, and we used univariate analysis to assess this influence on every single major complication,� said Claus, who presented findings at the 7th European Federation of National Associations of Orthopaedics and Traumatology Congress.

The researchers used Analysis of Variance (ANOVA) between groups to calculate the influence of age and length of surgery on major complications.

A 7% complication rate

Claus said that, overall, 7.22% of patients experienced complications. Hematoma was the most common complication, affecting 2.89% of patients, while cardiovascular complications affected 1.79%. Deep venous thrombosis occurred in 1.23% of patients, followed by pulmonary embolism (0.23%), joint infection (0.82%) and pneumonia (0.25%).

Men were found to be more prone to hematoma, joint infection and pneumonia immediately after surgery, while women proved more vulnerable to deep venous thrombosis.

Extended surgery time increased the rate of hematoma and infection. Advanced patient age also increased the rate of hematoma, cardiovascular complication and pneumonia, and allogeneic blood transfusion elevated the risk of all major complications except deep venous thrombosis, Claus said.

Claus and her associates performed an earlier study that found allogeneic blood transfusions sharply increasing the postoperative complication risk for patients who received total hip replacements [�Allogeneic blood transfusion raised complication risk for THA,� Orthopedics Today, April 2005, page 70; 1st on the Web, March 23, 2005.]. In that study, the researchers learned that allogeneic blood transfusions increased the cardiovascular complication risk by a factor of 3.9. Transfusions raised the risk of infection by a factor of 3.17.

For more information:

• Claus AM, Bosing-Schwenklengs M, Scharf H-P. Risk-profiling in knee arthroplasty based on postoperative complications of 17,644 arthroplasties. #F67. Presented at the 7th European Federation of National Associations of Orthopaedics and Traumatology Congress. June 4-7, 2005. Lisbon.