Risk analyses for perioperative morbidities after aseptic knee revision arthroplasty

被引:0
作者
Abdelghany, Ahmed [1 ]
Migliorini, Filippo [2 ]
Peterlein, Christian [1 ]
Goetze, Christian [3 ]
Koettnitz, Julian [1 ]
机构
[1] Univ Hosp RUB Bochum, Dept Gen Orthopaed, Auguste Viktoria Clin Bad Oeynhausen, D-32545 Bad Oeynhausen, Germany
[2] RWTH Aachen Univ Clin, Univ Clin Aachen, Dept Orthopaed & Trauma Surg, D-52064 Aachen, Germany
[3] Ruhr Univ Bochum, Univ Str 150, D-44801 Bochum, Germany
关键词
Age; Aseptic revision TKA; Blood transfusion; C-reactive protein; Perioperative complications; Gender; COMPLICATIONS; FAILURE; GENDER;
D O I
10.1007/s00402-024-05654-2
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Introduction Total lower limb arthroplasties are standard orthopedic surgeries that are steadily increasing in modern civilization. In proportion, the number of revision arthroplasties and the corresponding financial burden for healthcare systems will increase. The present clinical investigation analyzed morbidities after aseptic revision knee arthroplasty.Methods Data from 122 patients following aseptic revision TKA (total knee arthroplasty) were collected. The study collected information on systemic and surgical complications during hospitalization and follow-up, blood transfusion units, and changes in Hb and CRP levels. Hb and CRP were measured preoperatively and on postoperative days 1, 2, and 4. Statistical analyses were performed using IBM SPSS version 29.Results Significant differences were observed in systemic, surgery-related and blood transfusion rates and reasons for knee replacement changes based on age and gender. Of the patients, 38.5% received a full component change, 11.5% received a partial component replacement (either femoral or tibial), 30.3% had an isolated inlay change, and 19.7% underwent debridement only. Femoral and tibial loosening were more frequent in patients over 75 years and those with longer intervals between the initial operation and re-presentation (p = 0.001). Patients with movement deficits and malposition presented earlier for consultation (p = 0.02). Prolonged high CRP levels were significantly correlated with systemic complications, longer hospital stays, and extended operative times.Conclusions Aseptic knee revision arthroplasty is a complex procedure with perioperative morbidities that can significantly impact outcomes. Age and gender are crucial factors in managing complications during hospitalization and follow-up. Elderly patients, particularly those over 75 years, are more prone to aseptic loosening and require tailored preoperative preparation. The study underscores the importance of individualized patient care strategies to mitigate risks and improve outcomes in aseptic knee revision arthroplasty. Trial registration: Not applicable.Conclusions Aseptic knee revision arthroplasty is a complex procedure with perioperative morbidities that can significantly impact outcomes. Age and gender are crucial factors in managing complications during hospitalization and follow-up. Elderly patients, particularly those over 75 years, are more prone to aseptic loosening and require tailored preoperative preparation. The study underscores the importance of individualized patient care strategies to mitigate risks and improve outcomes in aseptic knee revision arthroplasty. Trial registration: Not applicable.
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