Objective: Lower extremity arterial injury is a rare complication following total knee (TKA) or total hip arthroplasty (THA). To date, no multi-institutional study has identified preoperative factors that may portend increased risk for these injuries. We queried a large clinical database for the incidence and predictors of arterial injury and/or compromise following lower extremity arthroplasty.
Methods: Prospectively collected preoperative and postoperative data by the National Surgical Quality Improvement Program (NSQIP) of the Veterans Affairs Medical Centers were analyzed. All patients from 1996 to 2003 in the NSQIP database who underwent TKA or THA were identified via CPT codes. NSQIP defined, 30-day, postoperative outcomes were analyzed. Data were compared using bivariable analysis, as well as limited multivariable logistic regression.
Results: A total of 41,633 arthroplasties (24,029 TKA, 2077 redo-TKA, 13,494 THA, 2033 redo-THA) were identified in the NSQIP database. A total of 34 (0.08%) lower extremity arterial injuries were recognized (0.08% TKA, 0.19% redo-TKA, 0.04% THA, 0.20% redo-THA). Eighteen injuries were repaired on the same day of surgery (seven intraop, 11 postop), eight between postoperative days 1 and 5, and 8 between days 6 and 30. Only two patients underwent lower extremity amputation (overall limb loss rate of 5.9% of patients who had arterial injury). Statistically significant predictors of lower extremity arterial injury identified on logistic regression analysis included redo procedure (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.2-6.0, P = .013) and African American race (OR 2.5, 95% CI 1.2-5.3, P = .02).
Conclusion: Lower extremity arterial injury was exceedingly rare after total knee or total hip arthroplasty. There is an increased incidence in African American patients and those undergoing redo arthroplasty. Among patients who sustain vascular injury, excellent limb salvage rates can be achieved with close postoperative surveillance to achieve early detection and repair of injuries.
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http://dx.doi.org/10.1016/j.jvs.2007.11.067 | DOI Listing |
J Burn Care Res
January 2025
Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Septic arthritis (SA) are rare in patients with burns, but delayed treatment can result in irreversible joint destruction. Early diagnosis and immediate treatment are necessary to prevent joint destruction. Robot training in patients with musculoskeletal diseases and burns, can improve joint range of motion (ROM), muscle strength, and lower extremity function.
View Article and Find Full Text PDFAccurate survival prediction of patients with long-bone metastases is challenging, but important for optimizing treatment. The Skeletal Oncology Research Group (SORG) machine learning algorithm (MLA) has been previously developed and internally validated to predict 90-day and 1-year survival. External validation showed promise in the United States and Taiwan.
View Article and Find Full Text PDFMethodsX
June 2025
Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198 Lleida, Montserrat, España.
Non-invasive brain stimulation (NIBS) techniques have emerged as a promising non-pharmacological adjunct to neurorehabilitation. Children with Cerebral Palsy (CP) exhibit altered cortical excitability, and while CP remains incurable, physiotherapy combined with other interventions is essential for managing motor dysfunction. Although some studies have examined NIBS using various stimulation parameters, there is limited evidence regarding its effects on the lower extremities and optimal administration protocols.
View Article and Find Full Text PDFJ Neuroeng Rehabil
January 2025
Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA.
Background: Advanced age brings a loss of plantar sensation, represented, for example, as higher sensation thresholds in standardized testing. This is thought to contribute to an increased risk of falls among older adults - an intuitive premise that has yet to be fully investigated, especially in the context of walking balance. The purpose of this study was to quantify the association between plantar sensation and the instability elicited by a suite of walking balance perturbations that differ in direction and context in a cohort of n = 28 older adults (73.
View Article and Find Full Text PDFBMC Emerg Med
January 2025
Ankara Etlik City Hospital, Emergency Medicine, Ankara, Turkey.
Objectives: Dysnatremia is a critical electrolyte disturbance that can significantly impact the prognosis of trauma patients by influencing fluid balance, neurological function, and hemodynamics. Although sodium disorder is common in hospitalized patients, few studies have specifically examined the incidence of dysnatremia in patients presenting to the emergency department for post-earthquake trauma. The aim of this study is to evaluate the incidence of dysnatremia and the prognosis of patients with dysnatremia in trauma patients admitted to our center after the Kahramanmaraş earthquake.
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