Timing and risk factors of complications following total knee arthroplasty

Total knee arthroplasty (TKA) is a common surgical procedure for end-stage arthritis; however, the precise timing of postoperative complications remains uncertain. This study aimed to estimate complication rates, timing, and risk factors associated with TKA.

Data from 846 patients with TKA treated at a single tertiary center, were scrutinized. Complications were categorized based on timing, whereas risk factors were assessed through logistic regression.

Most patients were aged >60 years (76.2%) and obese (78.4%). Urinary tract infection (UTI) was the most common complication (2.7%). Fever and hypernatremia each affected 1.8% of patients, whereas acute kidney injury (AKI) occurred in 1.4% of cases. Major complications typically arose within the first 4 days after surgery, with delirium, fever, and hyponatremia appearing earliest (median 2.0 days). Late complications included deep vein thrombosis (median 13.5 days) and surgical site infections (median 11.5 days). Risk factors included age ≥60 for UTI (odds ratio [OR]=9.09) and longer surgery duration for AKI (OR=1.01).

This study offers crucial insights into the risk factors and timing of complications after TKA. By identifying the risk factors and timing of post-TKA complications, clinicians can better tailor interventions, and improve patient care. Further research is needed to refine risk prediction models and optimize therapeutic strategies.