Background: The capacity for total knee arthroplasty to improve pain, quality of life, and functional outcomes is widely recognized. Postoperative mortality is rare but of paramount importance, and needs to be accurately quantified and conveyed to patients in order to support decision-making prior to surgery. The purpose of this study was to determine a contemporary estimate of the risk of mortality following total knee arthroplasty, including the identification of temporal trends, common causes, and modifiable and nonmodifiable risk factors.
Methods: We performed a systematic review with searches of MEDLINE, AMED, CAB Abstracts, and Embase. Studies in any language published from 2006 to 2016 reporting 30 or 90-day mortality following total knee arthroplasty were included, supplemented by contact with authors. Meta-analysis and meta-regression were performed for quantitative data.
Results: Thirty-seven studies with mortality data from 15 different countries following over 1.75 million total knee arthroplasties formed the basis of this review. The pooled Poisson-normal random-effects meta-analysis estimates of 30 and 90-day mortality were 0.20% (95% confidence interval [CI], 0.17% to 0.24%) and 0.39% (95% CI, 0.32% to 0.49%). Both estimates have fallen over the 10-year study period (p < 0.001). Meta-regression using the median year of surgery as a moderator showed that 30 and 90-day mortality following total knee arthroplasty fell to 0.10% (95% CI, 0.07% to 0.14%) and 0.19% (95% CI, 0.15% to 0.23%), respectively, in 2015. The leading cause of death was cardiovascular disease.
Conclusions: There is an ongoing worldwide temporal decline in mortality following total knee arthroplasty. Improved patient selection and perioperative care and a healthy-population effect may account for this observation. Efforts to further reduce mortality should be targeted primarily at reducing cardiovascular events following total knee arthroplasty.
Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2106/JBJS.17.00249 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Patient Perspective on Robotic-Assisted Total Joint Arthroplasty.
Arthroplast Today
February 2025
Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, D.C, USA.
Background: Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear.
View Article and Find Full Text PDFOptimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks.
Arthroplast Today
February 2025
Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Background: With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benchmarks would improve efficiency and the number of joints performed per day.
View Article and Find Full Text PDFOperative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis.
Arthroplast Today
February 2025
Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Background: Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system.
View Article and Find Full Text PDFInvestigating Postoperative Urinary Retention: Risk Factors and Postsurgical Outcomes in Total Joint Arthroplasty.
Arthroplast Today
February 2025
Department of Orthopedic Surgery, UCONN Health, Farmington, CT, USA.
Background: Postoperative urinary retention (POUR), a known complication following total joint arthroplasty (TJA), remains inconsistent in its diagnostic criteria, prevalence, and risk factors. This study aims to quantify POUR rates, identify risk factors, and assess complications associated with catheterization in TJA.
Methods: A single-center cohort undergoing TJA between January 2015 and December 2022 was retrospectively reviewed.
Endovascular therapy for iatrogenic occlusion of the popliteal artery after complex total knee arthroplasty: A case report.
J Vasc Surg Cases Innov Tech
April 2025
Department of Vascular Surgery, St Franziskus Hospital, Münster, Germany.
Iatrogenic arterial injury is an infrequent but limb-threatening complication of total knee arthroplasty (TKA). Open surgical reconstruction may not always be feasible or optimal, particularly in patients who have recently just undergone complex TKA procedures. In this report, we describe the treatment of a patient who developed popliteal artery occlusion following a complex TKA procedure performed the previous day.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!