Introduction: Mortality rates and causes of death after total knee arthroplasty (TKA) are of great interest to surgeons. However, there is a shortage of studies regarding those of the Asian population. The aim of this study was to compare the mortality rate and causes of death in patients after TKA to the general population. Methods: National sample cohort data from the Korean Health Insurance Review and Assessment Service were used. In this study, 1:4 matched patients after TKA (TKA group: 5072) and general participants (control group: 20,288) were selected as subjects. Their average follow-up duration was 57.2 months ranging from a year up to 12 years. The matches were processed for age, gender, income, region of residence, and past medical history. Mortality rates and causes of death were compared between groups. Regarding the mortality rates, we also performed subgroup analyses according to age. Results: Adjusted hazard ratio (HR) of the TKA group for mortality rate was less than 1 with significance (adjusted HR = 0.61 (95% confidence interval = 0.54–0.70, p < 0.001)). The ratios were less than 1 for both age groups (<70 and ≥70 years), respectively; however, for patients under 70, they were insignificant. Among the 11 major causes of death, the circulatory disease showed the most significantly reduced mortality rate for the TKA group compared to the control group. The neoplasm was the only other cause with a significantly reduced mortality rate for the TKA group. Conclusion: The mortality rate in the TKA group was significantly lower than in the control group up to 12 years after the surgery in Korea. Among the major causes of death, circulatory disease and neoplasm showed a significant reduction in the mortality rate of the TKA group compared with the control group.

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Background With an increase in deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in the Asian population, most surgeons today use a form of prophylactic anticoagulant agents in patients after TKA. Nevertheless, DVT occasionally develops even in these patients with prophylaxis. The purpose of this study was to identify the risk factors for DVT after TKA in cases of postoperative low-molecular-weight heparin (LMWH) use. Methods We designed a retrospective study with 103 patients who underwent primary TKA. From the second postoperative day, 60 mg of LMWH was subcutaneously injected into the patients daily. On the seventh postoperative day, patients had computed tomography angiography to check whether they had DVT. Regarding risk factors, we investigated patients’ gender, age, surgical site (unilateral/bilateral), body mass index, method of anesthesia, preoperative hypertension, diabetes, hypercholesterolemia status, and prothrombin time/international normalized ratio from electronic medical records. We analyzed the statistical significance of these risk factors. Results Statistically significant factors in the single-variable analysis were surgical site (unilateral/bilateral), body mass index, preoperative hypertension status, and anesthesia method. Multiple logistic regression analysis with these factors revealed that the surgical site (unilateral/bilateral, p = 0.024) and anesthesia method (p = 0.039) were significant factors for the occurrence of postoperative DVT after TKA. Conclusions Patients undergoing simultaneous bilateral TKAs and patients undergoing TKA with general anesthesia need more attention regarding DVT even with chemoprophylaxis using LMWH after TKA.

Introduction: The goal in treating anterior cruciate ligament (ACL) injury, especially in revision cases is to return to sports activity by regaining dynamic postural stability. Additional anterolateral ligament reconstruction (ALLR) is gaining attention to achieve this goal. The purpose was to evaluate the effects of additional ALLR in revision ACL reconstruction (RACLR). Methods: Patients who underwent RACLR between July 2015 and June 2018 were enrolled. The exclusion criteria were less than the 1-year follow-up, age older than 45 years, concomitant multiple ligament injuries, contralateral knee injury, subtotal or total meniscectomized state, and cartilage lesions worse than Outerbridge grade 3. Thirty-nine patients (20 patients; RACLR only (Group A), 19 patients; RACLR with additional ALLR (Group B)) were included. Clinical scores, isokinetic strength test, single-leg-hop for distance test (SLHDT), and Y-balance test (YBT) were checked preoperatively and 1-year postoperatively.Results: Limb symmetry index values in YBT showed significantly better results in Group B 1-year postoperatively, although there were no differences preoperatively between groups. Regarding clinical scores, isokinetic strength tests, and SLHDT, there were no differences between groups preoperatively or 1-year postoperatively.Conclusion: Additional ALLR in RACLR helped patients gain better dynamic postural stability at 1-year postoperative follow-up.