Related Experiment Video
Updated: Jan 9, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Total knee arthroplasty in patients with cardiomyopathy: A large matched cohort analysis
Hayden Flume1, Clarissa Meza2, Megan Sorich2
1Texas College of Osteopathic Medicine, UNT Health Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
Insights
Patients with cardiomyopathy undergoing total knee arthroplasty (TKA) face significantly higher risks for various postoperative complications. These include heart issues, blood clots, infections, and readmissions, highlighting cardiomyopathy as a critical risk factor.
Area of Science:
- Orthopedic Surgery
- Cardiology
- Health Outcomes Research
Background:
- Cardiomyopathy encompasses various heart muscle diseases that may necessitate orthopedic procedures like total knee arthroplasty (TKA).
- Understanding the risks associated with TKA in patients with cardiomyopathy is crucial for perioperative management and patient counseling.
Purpose of the Study:
- To investigate the demographic characteristics and 30-day postoperative complications in patients with cardiomyopathy undergoing TKA.
- To compare the outcomes of TKA between patients with and without cardiomyopathy.
Main Methods:
- A retrospective cohort study using the PearlDiver database.
- Inclusion of patients with cardiomyopathy who underwent TKA, identified via ICD-9, ICD-10, and CPT codes.
- 1:1 propensity score matching to compare outcomes between groups, with statistical significance set at p < 0.05.
Main Results:
- Patients with cardiomyopathy were older and exhibited significantly higher risks for congestive heart failure (3.076x), acute myocardial infarction (2.45x), postoperative shock (1.99x), deep vein thrombosis (1.25x), pulmonary embolism (1.56x), sepsis (1.37x), and acute kidney injury (1.36x).
- Increased risks were also observed for readmissions (1.23x) and revisions (1.26x).
- Local complications including periprosthetic joint infection, mechanical complications, manipulation under anesthesia, and wound dehiscence were more frequent in the cardiomyopathy group.
Conclusions:
- Cardiomyopathy is significantly associated with an increased risk of major adverse cardiovascular events, thromboembolic events, infectious complications, and acute organ dysfunction post-TKA.
- The findings underscore cardiomyopathy as a critical risk factor for adverse postoperative outcomes following total knee arthroplasty.
- These results emphasize the need for careful preoperative risk assessment and tailored postoperative care for patients with cardiomyopathy undergoing TKA.
Introduction:
Patients with cardiomyopathy, such as primary, infectious, inflammatory, secondary, and unspecified cardiomyopathy, may need total knee arthroplasty. This study aims to investigate the demographic and thirty-day postoperative complications of patients with cardiomyopathy who receive TKA.
Methods:
The PearlDiver database was utilized to develop a retrospective cohort study. Patients of all demographics diagnosed with cardiomyopathy who underwent TKA based on the ICD-9, ICD-10, and CPT diagnosis codes were included. A collection of preoperative and postoperative variables was compared between patients with cardiomyopathy and those without cardiomyopathy following TKA. A matched and unmatched univariant analysis was conducted to compare these two populations using a 1:1 propensity match algorithm. Statistical significance was set at p < 0.05, and odds ratios with 95 % confidence intervals were reported.
Results:
In 163,625 patients with cardiomyopathy, patients were older and had a 3.076 times greater risk of congestive heart failure (p < 0.0001), 2.4537 times greater risk of acute myocardial infarction (p < 0.0001), 1.995 times greater risk of postoperative shock (p < 0.0001), 1.2483 times greater risk of deep vein thrombosis (p < 0.0001), 1.5590 times greater risk of pulmonary embolism (p < 0.0001), 1.3694 times greater risk of sepsis (p < 0.0001), 1.3572 times greater risk of acute kidney injury (p < 0.0001)., 1.2277 times greater risk of readmissions (p < 0.0001), 1.2588 times greater risk of revisions (p < 0.0001), and higher risks of local complications such as periprosthetic joint infection (p = 0.0397), periprosthetic mechanical complication (p = 0.0213), manipulation under anesthesia (p = 0.0012) and wound dehiscence (p < 0.0001).
Conclusion:
Cardiomyopathy is associated with an increased risk of congestive heart failure, acute myocardial infarction, postoperative shock, deep vein thrombosis, pulmonary embolism, sepsis, acute kidney injury, readmissions, revisions, periprosthetic joint infection, mechanical complications, manipulation under anesthesia, and wound dehiscence. These results suggest that cardiomyopathy is a critical risk factor of adverse postoperative outcomes following TKA.
More Related Videos
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
01:25Cardiomyopathy I: Introduction and Classification
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management