Abstract
BackgroundTotal hip and total knee arthroplasty (THA/TKA) are increasing in incidence annually. While these procedures are effective in improving pain and function, there is a risk of complications.MethodsUsing data from an arthroplasty registry, we described complication rates including reasons for reoperation and readmission from the acute period to six months following THA and TKA in an Australian context. Data collection at 6 months was conducted via telephone interview, and included patient-reported complications such as joint stiffness, swelling and paraesthesia. We used logistic regression to identify risk factors for complications.ResultsIn the 8444 procedures included for analysis, major complications were reported by 9.5 and 14.4% of THA and TKA patients, respectively, whilst minor complications were reported by 34.0 and 46.6% of THA and TKA patients, respectively. Overall complications rates were 39.7 and 53.6% for THA and TKA patients, respectively. In THA patients, factors associated with increased risk for complications included increased BMI, previous THA and bilateral surgery, whereas in TKA patient factors were heart disease, neurological disease, and pre-operative back pain and arthritis in a separate joint. Female gender and previous TKA were identified as protective factors for minor complications in TKA patients.ConclusionWe found moderate rates of major and high rates of minor postoperative complications following THA and TKA in Australia and have identified several patient factors associated with these complications. Efforts should be focused on identifying patients with higher risk and optimising pre- and post-operative care to reduce the rates of these complications.
Highlights
Total hip and total knee arthroplasty (THA/Total Knee Arthroplasty (TKA)) are increasing in incidence annually
Characteristics of the study cohort Of 9458 procedures captured in Arthroplasty Clinical Outcomes Registry National (ACORN) between September 2012 and September 2018, 8444 procedures met the inclusion criteria for this study (2782 Total Hip Arthroplasty (THA) and 5662 TKA)
Patient characteristics associated with complications Our study found low back pain to be an independent predictor for major complications following either THA or TKA, and body mass index (BMI) as a risk factor for major complications following THA
Summary
Total hip and total knee arthroplasty (THA/TKA) are increasing in incidence annually While these procedures are effective in improving pain and function, there is a risk of complications. Over 90,000 THA and over 1.1 million TKA procedures were undertaken in 2018 in the UK, whilst in the US, incidence is estimated to grow to 572,000 THA and 3.48 million TKA procedures per annum by 2030 [2]. While these procedures are effective in improving pain and function [3,4,5,6,7], there is a risk of complications. Measuring and understanding rates of these events comprise important components of both informed consent and shared decision-making
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