Higher Risk of Complications After Total Knee Arthroplasty in Octogenarians

Abstract

Objective: To evaluate the complication rate of total knee arthroplasty (TKA) in octogenarian patients and identify predictive factors. Methods: The study comprised 70 octogenarians and 70 non-octogenarian patients as control group, all submitted to TKA. We analyzed the medical records of these patients, seeking for complications during the first postoperative year. Regarding the risk factors, we evaluated: age, sex, race, American Society of Anesthesiologists score, body mass index, smoking, hypertension and diabetes mellitus. Results: In the control group, the incidence of complications was 7.1%. Whereas in the octogenarian group it was significantly higher, reaching 34.3% (OR 6.8; 95% CI 2.4-19.1). We found no association to sex, skin color, and comorbidities. Age is an independent risk factor for postoperative complications. Our data may help patients to acknowledge the risks of undergoing primary TKA and physicians to assess and adjust perioperative risk. Conclusion: The incidence of postoperative complications is significantly higher in octogenarians. Level of Evidence III, Case-control study.

Fatores associados ao desenvolvimento de complicações precoces após artroplastia total do joelho

“…However, the literature suggests that the presence of comorbidities seems to be more relevant than age alone. 10 Among the comorbidities, it is worth noting that patients with diabetes mellitus had more complications in general, according to literature data, especially complications related to wound dehiscence and infections. 15 16 It was observed in the present study that patients with heart condition had a higher risk of developing arthrofibrosis, probably due to the difficulty in performing adequate rehabilitation, but further studies should be carried out to research this association.…”

“…No entanto, a literatura sugere que a presença de comorbidades parece ser mais relevante do que a idade isoladamente. 10 Dentre as comorbidades, vale notar que os pacientes portadores de diabetes mellitus apresentaram mais complicações em geral segundo dados da literatura, especialmente as complicações relacionadas com deiscência de feridas e infecções. 15 16 Observou-se no presente estudo que pacientes cardiopatas apresentaram maior risco de desenvolver artrofibrose, provavelmente por dificuldade de realizar uma reabilitação adequada, mas novos estudos devem ser realizados para investigas tal associação.…”

“…4 7 8 9 No entanto, novos estudos podem melhorar a capacidade do cirurgião de identificar pacientes com maior risco de complicações pós-operatórias para que elas sejam manejadas adequadamente com o uso de diferentes técnicas e estratégias. 10…”

“…4 7 8 9 However, new studies may improve the ability of the surgeon to identify patients at higher risk of postoperative complications so that they are properly managed using different techniques and strategies. 10…”

Octogenarians Are the New Sexagenarians: Cruciate-Retaining Total Knee Arthroplasty Is Not Inferior to Posterior-Stabilized Arthroplasty in Octogenarian Patients

“…This article categorically states an increase in mortality in terms of myocardial infarction, pulmonary embolism and deep-vein thrombosis. A few papers have quoted a statistically significant trend of mortality [28,29], but a few studies have contradicted the above trend, considering it as being non-significant [30,31]. In regard to the comparison of the complications/survival rates of the CR and PS designs, there is a lack of data.…”