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Erschienen in: Clinical Orthopaedics and Related Research® 1/2013

01.01.2013 | Symposium: Papers Presented at the Annual Meetings of the Knee Society

Complications of Total Knee Arthroplasty: Standardized List and Definitions of The Knee Society

verfasst von: William L. Healy, MD, Craig J. Della Valle, MD, Richard Iorio, MD, Keith R. Berend, MD, Fred D. Cushner, MD, David F. Dalury, MD, Jess H. Lonner, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 1/2013

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Abstract

Background

Despite the importance of complications in evaluating patient outcomes after TKA, definitions of TKA complications are not standardized. Different investigators report different complications with different definitions when reporting outcomes of TKA.

Questions/purposes

We developed a standardized list and definitions of complications and adverse events associated with TKA.

Methods

In 2009, The Knee Society appointed a TKA Complications Workgroup that surveyed the orthopaedic literature and proposed a list of TKA complications and adverse events with definitions. An expert opinion survey of members of The Knee Society was used to test the applicability and reasonableness of the proposed TKA complications. For each complication, members of The Knee Society were asked “Do you agree with the inclusion of this complication as among the minimum necessary for reporting outcomes of knee arthroplasty?” and “Do you agree with this definition?”

Results

One hundred two clinical members (100%) of The Knee Society responded to the survey. All proposed complications and definitions were endorsed by the members, and 678 suggestions were incorporated into the final work product. The 22 TKA complications and adverse events include bleeding, wound complication, thromboembolic disease, neural deficit, vascular injury, medial collateral ligament injury, instability, malalignment, stiffness, deep joint infection, fracture, extensor mechanism disruption, patellofemoral dislocation, tibiofemoral dislocation, bearing surface wear, osteolysis, implant loosening, implant fracture/tibial insert dissociation, reoperation, revision, readmission, and death.

Conclusions

We identified 22 complications and adverse events that we believe are important for reporting outcomes of TKA. Acceptance and utilization of these standardized TKA complications may improve evaluation and reporting of TKA outcomes.
Literatur
1.
Zurück zum Zitat Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed
3.
Zurück zum Zitat Conaghan PG, Emerton M, Tennant A. Internal construct validity of the Oxford Knee Scale: evidence from Rasch measurement. Arthritis Rheum. 2007;57:1363–1367.PubMedCrossRef Conaghan PG, Emerton M, Tennant A. Internal construct validity of the Oxford Knee Scale: evidence from Rasch measurement. Arthritis Rheum. 2007;57:1363–1367.PubMedCrossRef
4.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–213.PubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–213.PubMedCrossRef
5.
Zurück zum Zitat Dixon MC, Brown RR, Parsch D, Scott RD. Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. J Bone Joint Surg Am. 2005;87:598–603.PubMedCrossRef Dixon MC, Brown RR, Parsch D, Scott RD. Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. J Bone Joint Surg Am. 2005;87:598–603.PubMedCrossRef
6.
Zurück zum Zitat Dunbar MJ, Robertsson O, Ryd L, Lidgren L. Appropriate questionnaires for total knee arthroplasty: results of a survey of 3600 patients from the Swedish Knee Arthroplasty Registry. J Bone Joint Surg Br. 2001;83:339–344.PubMedCrossRef Dunbar MJ, Robertsson O, Ryd L, Lidgren L. Appropriate questionnaires for total knee arthroplasty: results of a survey of 3600 patients from the Swedish Knee Arthroplasty Registry. J Bone Joint Surg Br. 2001;83:339–344.PubMedCrossRef
7.
Zurück zum Zitat Fehring T, Odum S, Troyer J, Iorio R. Joint replacement access in 2016: a supply side crisis. J Arthroplasty. 2010;25:1175–1181.PubMedCrossRef Fehring T, Odum S, Troyer J, Iorio R. Joint replacement access in 2016: a supply side crisis. J Arthroplasty. 2010;25:1175–1181.PubMedCrossRef
8.
Zurück zum Zitat Fitzsimmons SE, Vazquez EA, Bronson MJ. How to treat the stiff total knee arthroplasty? A systematic review. Clin Orthop Relat Res. 2010;468:1096–1106.PubMedCrossRef Fitzsimmons SE, Vazquez EA, Bronson MJ. How to treat the stiff total knee arthroplasty? A systematic review. Clin Orthop Relat Res. 2010;468:1096–1106.PubMedCrossRef
9.
Zurück zum Zitat Goldhahn S, Sawaguchi T, Audige L, Mund R, Hanson B, Bhandari M, Goldhahn J. Complication reporting in orthopaedic trials: a systematic review of randomized controlled trials. J Bone Joint Surg Am. 2009;91:1847–1853.PubMedCrossRef Goldhahn S, Sawaguchi T, Audige L, Mund R, Hanson B, Bhandari M, Goldhahn J. Complication reporting in orthopaedic trials: a systematic review of randomized controlled trials. J Bone Joint Surg Am. 2009;91:1847–1853.PubMedCrossRef
10.
Zurück zum Zitat Healy WL, Rana A, Iorio R. Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res. 2011;469:87–94.PubMedCrossRef Healy WL, Rana A, Iorio R. Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res. 2011;469:87–94.PubMedCrossRef
11.
Zurück zum Zitat Hensyl WR, ed. Stedman’s Medical Dictionary. 25th ed. Baltimore, MD: Lippincott Williams & Wilkins; 1990:336. Hensyl WR, ed. Stedman’s Medical Dictionary. 25th ed. Baltimore, MD: Lippincott Williams & Wilkins; 1990:336.
12.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.PubMed Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.PubMed
13.
Zurück zum Zitat Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58:754–765.PubMed Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58:754–765.PubMed
14.
Zurück zum Zitat Iorio R, Robb WJ, Healy WL, Berry DJ, Hozack WJ, Kyle RF, Lewallen DG, Trousdale RT, Jiranek WA, Stamos VP, Parsley BS. Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg Am. 2008;90:1598–1605.PubMedCrossRef Iorio R, Robb WJ, Healy WL, Berry DJ, Hozack WJ, Kyle RF, Lewallen DG, Trousdale RT, Jiranek WA, Stamos VP, Parsley BS. Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg Am. 2008;90:1598–1605.PubMedCrossRef
15.
Zurück zum Zitat Kelly MA, Clarke HD. Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res. 2002;404:51–57.PubMedCrossRef Kelly MA, Clarke HD. Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res. 2002;404:51–57.PubMedCrossRef
17.
Zurück zum Zitat Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785.PubMedCrossRef
18.
Zurück zum Zitat Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467:2606–2612.PubMedCrossRef
19.
Zurück zum Zitat Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med. 2009;169:1102–1103, discussion 1121–1122.CrossRef Losina E, Walensky RP, Kessler CL, Emrani PS, Reichmann WM, Wright EA, Holt HL, Solomon DH, Yelin E, Paltiel AD, Katz JN. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med. 2009;169:1102–1103, discussion 1121–1122.CrossRef
20.
Zurück zum Zitat McHorney CA, Haley SM, Ware JE Jr. Evaluation of the MOS SF-36 Physical Functioning Scale (PF-10): II. Comparison of relative precision using Likert and Rasch scoring methods. J Clin Epidemiol. 1997;50:451–461.PubMedCrossRef McHorney CA, Haley SM, Ware JE Jr. Evaluation of the MOS SF-36 Physical Functioning Scale (PF-10): II. Comparison of relative precision using Likert and Rasch scoring methods. J Clin Epidemiol. 1997;50:451–461.PubMedCrossRef
21.
Zurück zum Zitat Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB. Development of a new Knee Society Scoring System. Clin Orthop Relat Res. 2012;470:20–32.PubMedCrossRef Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB. Development of a new Knee Society Scoring System. Clin Orthop Relat Res. 2012;470:20–32.PubMedCrossRef
22.
Zurück zum Zitat Parvizi J, Zmistowiski BS, Berbari EF, Baver TW, Spinger BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection (from the work group of the Musculoskeletal Infection Society). Clin Orthop Relat Res. 2011;469:2992–2994.PubMedCrossRef Parvizi J, Zmistowiski BS, Berbari EF, Baver TW, Spinger BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection (from the work group of the Musculoskeletal Infection Society). Clin Orthop Relat Res. 2011;469:2992–2994.PubMedCrossRef
23.
Zurück zum Zitat Ries MD, Philbin EF, Groff GD, Sheesley KA, Richman JA, Lynch F Jr. Improvement in cardiovascular fitness after total knee arthroplasty. J Bone Joint Surg Am. 1996;78:1696–1701.PubMed Ries MD, Philbin EF, Groff GD, Sheesley KA, Richman JA, Lynch F Jr. Improvement in cardiovascular fitness after total knee arthroplasty. J Bone Joint Surg Am. 1996;78:1696–1701.PubMed
24.
Zurück zum Zitat Robertsson O, Dunbar MJ. Patient satisfaction compared with general health and disease-specific questionnaires in knee arthroplasty patients. J Arthroplasty. 2001;16:476–482.PubMedCrossRef Robertsson O, Dunbar MJ. Patient satisfaction compared with general health and disease-specific questionnaires in knee arthroplasty patients. J Arthroplasty. 2001;16:476–482.PubMedCrossRef
25.
Zurück zum Zitat Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society Knee Scoring System. Clin Orthop Relat Res. 2012;470:3–19.PubMedCrossRef Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society Knee Scoring System. Clin Orthop Relat Res. 2012;470:3–19.PubMedCrossRef
26.
Zurück zum Zitat Soohoo NF, Zingmond DS, Lieberman JR, Ko CY. Optimal timeframe for reporting short-term complication rates after total knee arthroplasty. J Arthroplasty. 2006;21:705–711.PubMedCrossRef Soohoo NF, Zingmond DS, Lieberman JR, Ko CY. Optimal timeframe for reporting short-term complication rates after total knee arthroplasty. J Arthroplasty. 2006;21:705–711.PubMedCrossRef
27.
Zurück zum Zitat Veen SJ, Steenbruggen J, Roukema J. Classifying surgical complications: a critical appraisal. Arch Surg. 2005;140:1078–1083.PubMedCrossRef Veen SJ, Steenbruggen J, Roukema J. Classifying surgical complications: a critical appraisal. Arch Surg. 2005;140:1078–1083.PubMedCrossRef
28.
Zurück zum Zitat Watkins-Castillo S. Orthopaedic Practice in the US 2004–2005. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2004:1–4. Watkins-Castillo S. Orthopaedic Practice in the US 2004–2005. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2004:1–4.
Metadaten
Titel
Complications of Total Knee Arthroplasty: Standardized List and Definitions of The Knee Society
verfasst von
William L. Healy, MD
Craig J. Della Valle, MD
Richard Iorio, MD
Keith R. Berend, MD
Fred D. Cushner, MD
David F. Dalury, MD
Jess H. Lonner, MD
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 1/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2489-y

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