Introduction Arthroplasty procedures are commonly performed in the UK. Informed consent is required for each procedure. To obtain informed consent the patient and their surgeon should discuss the risks and benefits of the proposed operation. This discussion should include both regional and systemic complication rates. Regional complications of arthroplasty are generally well documented in the literature. Systemic medical complications are less well described. This lack of accurate data could make it difficult for the treating surgeon to obtain valid consent. The aim of this paper was to review and compare the literature regarding the rate of systemic medical complications after common arthroplasty procedures. Methods A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Studies regarding the systemic medical complications and mortality rate of joint replacement were included. Findings We found that systemic complications were more frequent than regional complications following arthroplasty. The systemic complication rates were: hip, 5.1%; knee, 6.9%; ankle, 3.0%; shoulder, 11.2%; elbow, 8.5%; and wrist, 0%. Mortality rates for arthroplasty procedures were: hip, 0.3%; knee, 0.2%; ankle, 0.3%; shoulder, 0.3%; elbow, 0.2%; and wrist, 0%. Conclusions The most common systemic medical complication following arthroplasty was venous thromboembolism. Preoperative comorbidity was the most important risk factor for both postoperative mortality and systemic medical complications following arthroplasty procedures. We recommend that to obtain informed consent the given rates of systemic medical complications of joint replacement should be discussed and documented.
Aim Total Ankle Arthroplasty (TAA) is increasingly being undertaken globally for the treatment of end-stage ankle arthritis. For each TAA procedure informed consent is required. This requires disclosing all material risks that the patient may find significant. The consent process should include discussion of all relevant complications, both medical and regional. There is a lack of data regarding the medical complications of TAA. This might cause problems in obtaining valid informed consent. Methods A literature review was performed. The medical complications and mortality rate of TAA were identified and summarised. Results The average rate of systemic medical complications after TAA was 3% (range: 0% - 7%). The average mortality rate following TAA was 0.3% (range: 0% - 0.72%). The following risk factors were identified for medical complications: obesity, diabetes, systemic co-morbidities, preoperative blood transfusion, revision procedures, and long anaesthetic duration. Conclusions As part of obtaining informed consent for TAA, the medical complication rate of 3% and mortality rate of 0.3% ought to be included, documented, and conveyed to patients alongside the regional complications.
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