School of Medicine and Health Sciences Poster Presentations
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
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Open Access
1
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