Factors Associated with the Development of Early Complications after Total Knee Arthroplasty

Tavares, Matheus Rizério; Alencar, Savio Diego Ribeiro de; Frazão, Samir Peixoto; Azi, Matheus Lemos; Sadgursky, David; Alencar, Daniel

doi:10.1055/s-0041-1736309

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Revista Brasileira de Ortopedia

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Original Article • Rev. bras. ortop. 57 (04) • Jul-Aug 2022 • https://doi.org/10.1055/s-0041-1736309 copy

Factors Associated with the Development of Early Complications after Total Knee Arthroplasty

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty

Methods

The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention.

Results

Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications.

Conclusions

Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Keywords
arthroplasty; arthroplasty, replacement, knee; comorbidities; complications; knee

Variables		n	%	Complications (%)		No complications (%)		p-value significance
Gender	Female	122	77.7	101	(82.8%)	21	(17.2%)	0.992^a
	Male	35	22.3	29	(82.9%)	6	(17.1%)
Age	< 70 years	65	41.4	0	(0.0%)	65	(100.0%)	<0.001^c
	≥ 70 years	92	58.5	27	(29.3%)	65	(70.7%)
ASA Score	I	32	20.4	28	(87.5%)	4	(12.5%)	0.881^a
	II	105	66.9	86	(81.9%)	19	(18.1%)
	III	19	12.1	15	(78.9%)	4	(21.1%)
	IV	1	0.6	1	(100.0%)	0	(0.0%)
Number of comorbidities	None	33	21	29	(87.9%)	4	(12.1%)	0.045^b
	1	73	46.5	62	(84.9%)	11	(15.1%)
	2	42	26.8	34	(81.0%)	8	(19.0%)
	3	8	5.1	5	(62.5%)	3	(37.5%)
	4	1	0.6	0	(0.0%)	1	(100.0%)
Arterial hypertension		111	71.3	91	(82.0%)	21	(18.9%)	0.416^a
Diabetes mellitus		36	22.9	26	(72.2%)	10	(27.8%)	0.055^a
Heart disease		6	3.8	4	(66.7%)	2	(33.3%)	0.286^a
Rheumatoid arthritis		8	5.1	6	(75.0%)	2	(25.0%)	0.414^a
Obesity		4	2.5	4	(100.0%)	0	(0.0%)	0.466^a
Hypothyroidism		4	2.5	3	(75.0%)	1	(25.0%)	0.675^a
Psychiatric disorder		4	2.5	4	(100.0%)	0	(0.0%)	0.356^a
Renal insufficiency		2	1.3	1	(50.0%)	1	(50.0%)	0.216^a
Asthma		2	1.3	1	(50.0%)	1	(50.0%)	0.216^a
Hepatitis C		1	0.6	1	(100.0%)	0	(0.0%)	0.648^a

Variables		n	%	Complications (%)		No complications (%)		p-value significance
Gonarthrosis	Bilateral	88	56.1	75	(85.20%)	13	(14.80%)	0.366
	Unilateral	69	43.9	55	(79.70%)	14	(20.30%)
Ahlbäck grading	III	5	3.2	3	(60.00%)	2	(40.00%)	0.258
	IV	94	59.9	83	(88.30%)	11	(11.70%)
	V	58	36.9	44	(75.90%)	14	(24.10%)
Deformity	Varus	140	89.2	116	(82.90%)	24	(17.10%)	0.959
	Valgus	17	10.8	14	(82.40%)	3	(17.60%)
Prosthesis	Primary	149	94.9	123	(82.60%)	26	(17.40%)	0.72
	Revision	8	5.1	7	(87.50%)	1	(12.50%)
Surgery laterality	Left	86	54.8	71	(82.60%)	15	(17.40%)	0.929
	Right	71	45.2	59	(83.10%)	12	(16.90%)
Suction drain	Used	140	89.2	27	(19.30%)	113	(80.70%)	0.047
	Not Used	17	10.8	0	(0.00%)	17	(100.00%)

Complications	Frequency	Percentage
No complications	130	82.8
Arthrofibrosis	10	6.4
Deep infection	7	4.4
Superficial infection	4	2.5
Persistent pain	3	0.6
Periprosthetic fracture	1	0.6
Acute Kidney injury	1	0.6
Urinary Tract infection	1	0.6
Total	157	100.0

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Matheus Rizério Tavares, MD, Hospital Manoel Victorino, Ortopedia e Traumatologia, Praça Conselheiro Almeida Couto, SN, Nazaré. Salvador, Bahia, Brasil (e-mail: matheus.tavares@gmail.com).