Complications Rates After Total Knee Arthroplasty in Patients With Peripheral Vascular Disease

As the population continues to grow and age, the number of projected total knee arthroplasty (TKA) procedures is expected to grow substantially by 2030. This retrospective study reviews peripheral vascular disease (PVD) and correlations between postoperative complications in patients undergoing TKA with concomitant PVD. Patient deidentified data were queried using an enterprise-wide database from January 2016 to July 2023. A total of 11,831 initial patients over the age of 50 that had undergone TKA were found, and 446 patients were removed due to missing demographic information leaving 11,385 patients for analysis. Patients were then separated into two cohorts: group 1 underwent TKA with an ICD-10 documented diagnosis of PVD and group 2 that underwent TKA without a concomitant diagnosis of PVD. Chi-squared analysis was then performed to identify statistical differences in postoperative complications between the two cohorts. Group 1 had developed a surgical site infection (SSI) in 5.21% compared with 4.66% in Group 2 (p = 0.28). Arthrofibrosis developed in 0.85% in Group 1 and 0.78% in Group 2 (p = 0.71). The mortality rate after TKA was not significantly different between the two groups (p = 0.31). Venous thromboembolism (VTE) was present in 10.06% in Group 1 and 5.34% of patients in Group 2 (p < 0.0001). New arrhythmia, pneumonia, delirium, and urinary tract infection were all increased in Group 1 patients (p < 0.001). Patients with PVD (Group 1) had a statistically significant longer length of stay (LOS) compared with patients without PVD (Group 2), controlling for age, sex, and race (interrater reliability = 1.31, p < 0.001). The results of this retrospective study demonstrate an increased LOS, increase in medical complications, and a statistically significant difference in VTE rates in patients with a history of PVD undergoing TKA as compared with those without. There was no significant difference in arthrofibrosis, SSI, and mortality in patients receiving TKA with a history of PVD compared with without PVD.