Predictive value of lower extremity color doppler ultrasonography before knee arthroplasty on a postoperative...

The study intended to determine the presence of lower limb arterial calcification (LLAC) in lower extremity color Doppler ultrasonography (CDUS) before primary total knee arthroplasty (TKA) and its relation with cardiovascular events (CVE) during knee arthroplasty and the postoperative period, as well as to investigate its effect on surgical risk estimation.

We designed this study as a retrospective cohort study. The study comprised 467 patients who met the inclusion criteria and had surgery for a primary gonarthrosis diagnosis between January 2005 and December 2015 were included. In the study group, patients with arterial calcification in the lower extremity CDUS were included; however, those reported not to have it were included in the control group. The research data were obtained from preoperative anesthesia records and patient medical records.

72% of the sample had preoperative cardiovascular comorbidity. There was no difference between the groups in terms of comorbidities, except for congestive heart failure (CHF) and peripheral artery disease (PAD). The groups did not differ in terms of ASA scores, either. Both pre- and post-operative CVEs, i.e., ischemic heart disease, dysrhythmia, and CHF, were statistically high in the study group. In terms of postoperative mortality, there was no statistical difference between the groups.

The study demonstrates that the presence of LLAC in CDUS is associated with increased risk of perioperative cardiovascular events (CVEs). Ultrasonographic detection of LLAC may give some idea the surgeon about the requirement for additional preoperative cardiac examinations.