Perioperative morbidity in total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Geriatric Medicine

Background:

• Increasing life expectancy and obesity rates lead to more elderly and overweight patients undergoing total knee arthroplasty (TKA).
• Total knee arthroplasty (TKA) carries risks of perioperative complications, including anesthesia-related issues, exacerbation of medical conditions, and surgical problems.
• Limited data exists on medical complications following TKA in specific populations.

Purpose of the Study:

• To evaluate the incidence of perioperative complications in patients undergoing total knee arthroplasty (TKA).
• To identify significant risk factors associated with these perioperative complications.

Main Methods:

• A retrospective monocentric study analyzed 410 cases from a TKA registry (January 2014 - December 2017).
• Standardized anesthesia and postoperative care protocols were applied for three days post-surgery.
• Multivariate logistic regression was employed to determine predictors of complications.

Main Results:

• The overall incidence of perioperative complications was 37.1%.
• Most frequent complications included intraoperative hypotension (14.1%) and postoperative desaturation (21.7%, with 2.4% pulmonary embolism).
• Significant risk factors for any complication were age ≥ 65 years, respiratory diseases, and general anesthesia. Age ≥ 65, female gender, and respiratory diseases were linked to postoperative desaturation.

Conclusions:

• Hemodynamic and respiratory complications are the most frequent early complications following total knee arthroplasty (TKA).
• Advanced age (≥ 65 years), general anesthesia, and pre-existing respiratory diseases are identified as significant risk factors for these complications.