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Perioperative stroke after total joint arthroplasty: prevalence, predictors, and outcome

S M Javad Mortazavi1, Hasan Kakli, Orhan Bican

  • 1Rothman Institute of Orthopedics, Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA 19107, USA.

The Journal of Bone and Joint Surgery. American Volume
|September 3, 2010
PubMed

Insights

Perioperative stroke is a rare but serious complication after total joint arthroplasty. Identifying risk factors like heart disease and urgent surgery can help prevent these devastating events.

Area of Science:

  • Orthopedic Surgery
  • Neurology
  • Public Health

Background:

  • Perioperative stroke is a known risk in cardiac and carotid surgery.
  • This complication is often overlooked following total joint arthroplasty (TJA).
  • Understanding TJA-related stroke prevalence and risk factors is crucial.

Purpose of the Study:

  • Determine the prevalence and outcomes of perioperative stroke after TJA.
  • Identify patient and surgery-related risk factors for stroke.
  • Develop strategies to minimize stroke incidence post-TJA.

Main Methods:

  • Observational study of 18,745 patients undergoing hip or knee arthroplasty (2000-2007).
  • Analysis of institutional stroke rate (0.2%).
  • Evaluation of patient and surgical factors using a predictive model.

Main Results:

  • The perioperative stroke rate was 0.2% (36/18,745 patients).
  • First-year mortality for stroke patients was 25%.
  • Significant predictors included noncoronary heart disease, urgent surgery, general anesthesia, and intraoperative arrhythmias.

Conclusions:

  • Perioperative stroke is a rare but severe complication of TJA.
  • High morbidity and mortality rates are associated with TJA-related stroke.
  • Timely prevention, detection, and treatment are vital for improving outcomes.
Abstract

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