Stroke History and Time Elapsed are Predictors of Complications in Total Knee Arthroplasty.
J Arthroplasty
; 39(4): 921-926, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-37852444
ABSTRACT
BACKGROUND:
A consensus has not been reached regarding the optimal timing of elective total knee arthroplasty (TKA) following a stroke. The purpose of this study was to examine the optimal period between stroke and TKA to minimize complications. Specifically, we assessed (1) medical and surgical complications; (2) timing of stroke and TKA; (3) associated risk factors.METHODS:
A national database identified 69,815 TKA patients that were separated into 6 exclusive cohorts using a stratum likelihood ratio no stroke (n = 20,000), stroke within 6 (n = 17,764), 12 (n = 10,338), 18 (n = 8,370), 24 (n = 7,121), and 30 months (n = 6,222) prior to TKA. We analyzed 90-day, 1-year, and 2-year complications in each subgroup. Multivariate analyses were used to identify risk factors for periprosthetic joint infection (PJI).RESULTS:
The multivariate regression model identified that patients with a stroke within 6 months of TKA had increased risk of PJI at all time points (P < .001). Also, stroke 12 to 18 months before TKA elevated PJI risk at 1 and 2 years (all P < .021), while those over 18 months did not show a significant risk compared to controls (P > .067).CONCLUSIONS:
Stroke prior to TKA was associated with an increased risk of postoperative complications, specifically PJI. We recommend a minimum of 6 months between stroke and TKA, with 18 months offering the lowest risk.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthritis, Infectious
/
Prosthesis-Related Infections
/
Arthroplasty, Replacement, Knee
/
Stroke
Limits:
Humans
Language:
En
Journal:
J Arthroplasty
Journal subject:
ORTOPEDIA
Year:
2024
Type:
Article