HIGHER RISK OF COMPLICATIONS AFTER TOTAL KNEE ARTHROPLASTY IN OCTOGENARIANS

The study comprised 70 octogenarians and 70 non-octogenarian patients as control group, all submitted to TKA. We analyzed the medical records of these patients, seeking for complications during the first postoperative year. Regarding the risk factors, we evaluated: age, sex, race, American Society of Anesthesiologists score, body mass index, smoking, hypertension and diabetes mellitus.

Results:

In the control group, the incidence of complications was 7.1%. Whereas in the octogenarian group it was significantly higher, reaching 34.3% (OR 6.8; 95% CI 2.4-19.1). We found no association to sex, skin color, and comorbidities. Age is an independent risk factor for postoperative complications. Our data may help patients to acknowledge the risks of undergoing primary TKA and physicians to assess and adjust perioperative risk.

Conclusion:

The incidence of postoperative complications is significantly higher in octogenarians. Level of Evidence III, Case-control study.

Keywords:
Arthroplasty. Knee. Postoperative Complications. Aged; 80 and over

Statistics	Overall	Female	Male
Minimum	60	60	60
Maximum	94	94	90
Mean	73.0	74.1	69.5
Standard deviation	10.3	10.3	9.8
Median	73	80	64
CV	0.14	0.14	0.14
KS test p value	0.000	0.000	0.000
SW test p value	0.000	0.000	0.000

Characteristic	Overall		Non-octogenarians		Octogenarians		test p-value
Characteristic	F	%	F	%	F	%
Gender
Female	107	76.4%	47	67.1%	60	85.7%	0.010
Male	33	23.6%	23	32.9%	10	14.3%
Skin color
White	56	40.0%	21	30.0%	35	50.0%	0.054
Mixed race	65	46.4%	38	54.3%	27	38.6%
Black	19	13.6%	11	15,7%	8	11.4%
Comorbidities
SAH	119	85.0%	58	82.9%	61	87.1%	0.478
DM	24	17.1%	11	15,7%	13	18.6%	0.654
Obesity	17	12.1%	14	20.0%	3	4.3%	0.004
Hypo/hyperthyroidism	11	7.9%	3	4.3%	8	11.4%	0.116
Depression	8	5.7 %	4	5.7 %	4	5.7 %	1,000^(b)
Dyslipidemia	8	5.7 %	2	2.9%	6	8.6%	0.275^(b)
Smoking	7	5.0%	5	7.1%	2	2.9%	0.441^(b)
Prostate	5	3.6%	0	0.0%	5	7.1%	0.058^(b)
Bronchitis/Asthma	4	2.9%	1	1.4%	3	4.3%	0.620
Prior CVA	3	2.1%	0	0.0%	3	4.3%	0.245^(b)
Anemia	2	1.4%	1	1.4%	1	1.4%	1,000^(b)
AF	2	1.4%	1	1.4%	1	1.4%	1,000^(b)
CRF	2	1.4%	1	1.4%	1	1.4%	1,000^(b)
Epilepsy	1	0.7%	0	0.0%	1	1.4%	1,000^(b)
Gout	1	0.7%	1	1.4%	0	0.0%	1,000^(b)
Hepatopathy	1	0.7%	0	0.0%	1	1.4%	1,000^(b)
Panic Disorder	1	0.7%	0	0.0%	1	1.4%	1,000^(b)

Description of complication	Overall		Non-octogenarians		Octogenarians
Description of complication	F	%	F	%	F	%
Loss of range of motion	5	3.5	3	4.2	2	2.8
TKA infection	3	2.1	2	2.9	1	1.4
Anemia	2	1.4	0	0	2	2.8
Cellulitis	2	1.4	0	0	2	2.8
Chronic pain	2	1.4	0	0	2	2.8
Periprosthetic fracture	2	1.4	0	0	2	2.8
Peroneal neuropraxia	2	1.4	0	0	2	2.8
Deep vein thrombosis	2	1.4	0	0	2	2.8
Anasarca/ IPO Hyponatremia	1	0.7	0	0	1	1.4
IPO Decompensated asthma	1	0.7	0	0	1	1.4
IPO Pulmonary congestion	1	0.7	0	0	1	1.4
Delirium/ IPO ARF	1	0.7	0	0	1	1.4
IPO AF	1	0.7	0	0	1	1.4
IPO Hematoma/Surgical Dressing	1	0.7	0	0	1	1.4
Ligament injury during TKA - Indicated by TC3 Review	1	0.7	0	0	1	1.4
Delaying Wound Healing	1	0.7	0	0	1	1.4
Intestinal sub-occlusion	1	0.7	0	0	1	1.4

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Gabriel Garcez de Araujo Souza. Rua Santa Clara, 50, sala 421, Rio de Janeiro, RJ, Brazil, 22041012. drgabrielgarcez@genutarso.com.br