Complication Rates in Total Knee Arthroplasty Performed for Osteoarthritis and Post-Traumatic Arthritis: A Comparison Study

Brockman, Bryan S.; Maupin, Jeremiah J.; Thompson, Samuel F; Hollabaugh, Kimberly; Thakral, Rishi

doi:10.1016/j.arth.2019.09.022

Cited by 34 publications

(23 citation statements)

References 16 publications

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“…B.S. Brocker et al identified a comparison study between PTOA and primary OA undergoing TKA using the NIS database (National Inpatient Sample), and they demonstrated that patients with primary OA had a higher prevalence of obesity, diabetes, heart disease, and lung disease [20]. This study was comparable with the NIS database in that the primary OA group had higher comorbidities, including higher CCI (p<0.0001).…”

Section: Discussionmentioning

confidence: 70%

“…This study showed no difference in surgical site infection in both groups (1.5% vs. 0.3%, p=0.262) even though there was the statistical significance of operative time among the three groups. Previous studies defined that PTOA had a significantly higher rate of superficial wound infection than primary OA following TKR (p<0.001) [20] and the PTOA group had a significantly higher likelihood of wound complication than those with primary OA patients (odd ratio 1.8 with 95% confidential interval between 1.55 and 2.09, p<0.001) [21]. In addition, Peersman et al demonstrated a longer operative time related to surgical site infection in TKR [22].…”

Section: Discussionmentioning

confidence: 95%

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TKR after posttraumatic and primary knee osteoarthritis: a comparative study

et al. 2021

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Background A few literatures reported that the outcomes of total knee replacement (TKR) in posttraumatic osteoarthritis (PTOA) were lower compared to TKR in primary osteoarthritis (primary OA). The study’s purpose was to compare the comorbidity and outcome of TKR among fracture PTOA, ligamentous PTOA, and primary OA. The secondary aim was to identify the effect of postoperatively lower limb mechanical axis on an 8-year survivorship after TKR between PTOA and primary OA. Methods Seven hundred sixteen patients with primary OA, 32 patients with PTOA (knee fracture subgroup), and 104 PTOA (knee ligamentous injury subgroup) were recruited. Demography, comorbidities, Charlson Comorbidity Index (CCI), operative parameters, mechanical axis, functional outcome assessed by WOMAC, and complications were compared among the three groups. Results PTOA group was significantly younger (p<0.0001) with a higher proportion of men (p=0.001) while the primary OA group had higher comorbidities than the PTOA group, including anticoagulant usage (p=0.0002), ASA class ≥3 (p<0.0001), number of diseases ≥ 4 (p<0.0001), and CCI (p<0.0001). Both the fracture PTOA group (p<0.0001) and ligamentous PTOA group (p = 0.009) had a significantly longer operative time than the primary OA group. The fracture PTOA group had significantly lower pain components and stiffness components than the primary OA group. There was no significant difference in the rate of an aligned group, outlier group, and an 8-year survivorship in both groups. Conclusion The outcome following TKR in the fracture PTOA was poorer compared to primary knee OA in the midterm follow-up. However, no difference was detected between the ligamentous PTOA and primary knee OA. The mechanical axis alignment within the neutral axis did not affect the 8-year survivorship after TKR in both groups. Level of evidence Level III; retrospective cohort study

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 95%

TKR after posttraumatic and primary knee osteoarthritis: a comparative study

et al. 2021

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“…Among the 4 wound events of aspirin group, one was surgical site infection and others were poor wound healing, which indicated the aspirin use might affect the wound healing. It draws the attention regarding adverse effects of aspirin usage on wound healing, especially for patients with high risk of wound events, such as patients with RA or post-traumatic arthritis [14,23].…”

Section: Discussionmentioning

confidence: 99%

Continuing use of aspirin in total knee arthroplasty: safe or not?

Zeng

Xiang

et al. 2021

Preprint

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Background: There are a growing number of patients who take aspirin routinely before TKA to prevent vascular events. However, it may increase the risk of bleeding and wound complications. It remains controversial regarding the safety of continuing use of aspirin during the perioperative period of TKA. Methods: The present study retrospectively selected TKA cases from the Joint Arthroplasty Database at the Peking Union Medical College Hospital from January 2014 to December 2019. The comparisons between the aspirin group and non-aspirin group on the aspects of bleeding parameters (blood loss, transfusion rate, drainage volume, hemoglobin and hematocrit change) and complications (cardiac events, venous thromboembolism events, cerebrovascular events and wound events) were performed. Results: A total of 560 patients with unilateral TKA and 285 patients with bilateral TKA were extracted. Among those, 280 patients used aspirin preoperatively. No differences were found in demographic and surgical characteristics between the aspirin and non-aspirin group except for the proportion of coronary artery diseases (p<0.05). For the outcomes, there were no significant higher blood loss in the surgery and transfusion rate during or after the surgery in the aspirin group, while the drainage in the aspirin group was higher than control group, especially for bilateral TKAs (p=0.043). And the hemoglobin and hematocrit in POD5 in aspirin group were significant lower in both unilateral and bilateral TKAs. For complications, though there were lower vascular related complication rate in aspirin group after unilateral TKAs (p=0.040), the wound event rate in aspirin group were higher than the control group (p=0.049). Conclusion: Continuing use of aspirin could prevent vascular related complications during the perioperative period of TKA. However, it might also increase the risk of bleeding and wound complications which we should pay attention to.

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“…Total knee arthroplasty (TKA) is a common and effective orthopedic procedure to treat severe osteoarthritis and rheumatoid arthritis. 1 Periprosthetic joint infection(PJI) proves to be a serious complication following TKA. 2 Although the overall incidence of PJI is low at 0.5–2.0% after primary TKA, it still brings a large burden on patients’ health and finance.…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic Joint Infection Caused by Mycoplasma hominis, Diagnosed Using Metagenomic Sequencing

Wang¹,

Ren²,

Li³

et al. 2021

IJGM

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To our knowledge, the periprosthetic joint infection (PJI) caused by Mycoplasma hominis is a rare postoperative complication after total knee arthroplasty (TKA). Just a few cases associated with Mycoplasma hominis infection after TKA were reported all over the world currently. In view of the difficulty involved in isolating this microorganism, Mycoplasma hominis infection may be under-recognized and should be considered in culture-negative cases where the microbial etiology is not easily identified. Metagenomic sequencing is a new tool to identify pathogens undetected by conventional methods. In this report, we present a case where metagenomic sequencing was used to identify Mycoplasma hominis as a novel PJI pathogen after TKA in our hospital.

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Complication Rates in Total Knee Arthroplasty Performed for Osteoarthritis and Post-Traumatic Arthritis: A Comparison Study

Cited by 34 publications

References 16 publications

TKR after posttraumatic and primary knee osteoarthritis: a comparative study

TKR after posttraumatic and primary knee osteoarthritis: a comparative study

Continuing use of aspirin in total knee arthroplasty: safe or not?

Periprosthetic Joint Infection Caused by Mycoplasma hominis, Diagnosed Using Metagenomic Sequencing

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