School of Medicine and Health Sciences Poster Presentations

Title

Perioperative Complications and Impact of Operation Time on Revision Total Knee Arthroplasty

Poster Number

209

Document Type

Poster

Status

Medical Student

Abstract Category

Clinical Specialties

Keywords

revision, knee, arthroplasty, operation length, postoperative

Publication Date

Spring 2018

Abstract

Background: Total knee arthroplasty (TKA) is a common and effective treatment of knee osteoarthritis. As more TKAs are performed, there will be more subsequent revisions and failures. In multiple studies, operation length was shown to be a risk factor for postoperative infection and venous thromboembolism. Thus, it is important to understand the association between length of operation time and the risk of these various postoperative complications following revision TKA.

Methods: A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent unilateral revision TKAs between 2007 and 2014 were identified and sorted into three different cohorts- below standard operation length (BSOL), standard operation length (SOL), and above standard operation length (ASOL). SOL was defined as between 40-100 minutes. Univariate and multivariate analyses were used to evaluate the incidence of multiple 30-day adverse outcomes after revision TKA with statistical significance as p<.05.

Results: Patients that were BSOL were more likely to develop a deep surgical site infection (OR 3.3; CI 1.2-9.0; p=0.017) compared to SOL. Patients that were ASOL were more likely to develop a pulmonary embolism (OR 2.5; CI 1.1-6.1; p=0.038), but less likely to develop an organ/space infection (OR 0.5; CI 0.4-0.7; p<0.001) or sepsis (OR 0.5; CI 0.3-0.6; p>0.001) compared to patients with SOL.

Conclusion: Relative to patients with SOL, those with BSOL or ASOL have a greater likelihood of developing certain postoperative complications. However, there were also certain decreased risks associated with ASOL, particularly infection. Orthopedic surgeons should keep in consideration the implication of operation time as a risk factor for postoperative outcomes.

Keywords: revision, knee, arthroplasty, operation length, postoperative

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

1

This document is currently not available here.

Share

COinS
 

Perioperative Complications and Impact of Operation Time on Revision Total Knee Arthroplasty

Background: Total knee arthroplasty (TKA) is a common and effective treatment of knee osteoarthritis. As more TKAs are performed, there will be more subsequent revisions and failures. In multiple studies, operation length was shown to be a risk factor for postoperative infection and venous thromboembolism. Thus, it is important to understand the association between length of operation time and the risk of these various postoperative complications following revision TKA.

Methods: A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent unilateral revision TKAs between 2007 and 2014 were identified and sorted into three different cohorts- below standard operation length (BSOL), standard operation length (SOL), and above standard operation length (ASOL). SOL was defined as between 40-100 minutes. Univariate and multivariate analyses were used to evaluate the incidence of multiple 30-day adverse outcomes after revision TKA with statistical significance as p<.05.

Results: Patients that were BSOL were more likely to develop a deep surgical site infection (OR 3.3; CI 1.2-9.0; p=0.017) compared to SOL. Patients that were ASOL were more likely to develop a pulmonary embolism (OR 2.5; CI 1.1-6.1; p=0.038), but less likely to develop an organ/space infection (OR 0.5; CI 0.4-0.7; p<0.001) or sepsis (OR 0.5; CI 0.3-0.6; p>0.001) compared to patients with SOL.

Conclusion: Relative to patients with SOL, those with BSOL or ASOL have a greater likelihood of developing certain postoperative complications. However, there were also certain decreased risks associated with ASOL, particularly infection. Orthopedic surgeons should keep in consideration the implication of operation time as a risk factor for postoperative outcomes.

Keywords: revision, knee, arthroplasty, operation length, postoperative