Research Article

Investigating the Correlations between Patient Demographics and Complications Following Total Knee Arthroplasty: A Cross-Sectional Study

Abstract

Introduction: This study investigates the relationship between patient age, gender, and various complications, such as pain, restricted range of motion (ROM), and hemorrhage following total knee arthroplasty.
Materials and Methods: This cross-sectional study included 62 patients (Mean±SD age= 65.9±7.38 years; female participants=74.2%) who underwent total knee arthroplasty at Atieh Hospital in Tehran, Iran, between 2020 and 2021. Pain levels were assessed using the numerical pain rating score. Meanwhile, knee joint ROM was evaluated using a reliable mobile application. Hemorrhage was measured through knee joint drainage. Statistical analyses were performed to analyze the data.
Results: Women reported higher pain levels and more restricted ROM in passive knee extension and active/passive knee flexion compared to men (P<0.05). However, no significant differences were observed between genders in active knee extension and hemorrhage. A significant inverse correlation was found between pain and ROM in passive knee extension (rho=-0.41, P≤0.001), as well as in active (rho=-0.5, P≤0.001) and passive knee flexion (rho= -0.59, P≤0.001). However, no significant relationship was observed between pain and active knee extension or hemorrhage. Age showed no statistically significant correlation with the other variables.
Conclusion: This study highlights the association between higher pain levels and greater ROM restrictions in passive knee extension and active/passive knee flexion following total knee arthroplasty; however, patient age and gender were not found to be associated with postoperative hemorrhage. These findings underscore the importance of closely monitoring pain and ROM, particularly in women undergoing total knee arthroplasty.

Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316-22.

Pereira D, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011;19(11):1270-85.

Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3-25.

Thacoor A, Sandiford NA. Cryotherapy following total knee arthroplasty: What is the evidence? J Orthop Surg (Hong Kong). 2019;27(1):2309499019832752.

Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med. 2000;133(9):726-37.

Naylor JM, Harmer AR, Heard RC, Harris IA. Patterns of recovery following knee and hip replacement in an Australian cohort. Aust Health Rev. 2009;33(1):124-35.

Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br. 2004;86(4):561-5.

Duellman TJ, Gaffigan C, Milbrandt JC, Allan DG. Multi-modal, pre-emptive analgesia decreases the length of hospital stay following total joint arthroplasty. Orthopedics. 2009;32(3):167.

Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-7.

Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804.

Hancock GE, Hepworth T, Wembridge K. Accuracy and reliability of knee goniometry methods. J Exp Orthop. 2018;5(1):46.

Adie S, Kwan A, Naylor JM, Harris IA, Mittal R. Cryotherapy following total knee replacement. Cochrane Database Syst Rev. 2012(9):Cd007911.

Daigle ME, Weinstein AM, Katz JN, Losina E. The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol. 2012;26(5):649-58.

Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86(5):963-74.

Robertsson O, W-Dahl A, Lidgren L, Sundberg M. Annual report 2015 - The Swedish Knee Arthroplasty Register2015.

Li JW, Ma YS, Xiao LK. Postoperative Pain Management in Total Knee Arthroplasty. Orthop Surg. 2019;11(5):755-61.

Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. 2013;111(1):52-8.

Kinoshita T, Hino K, Kutsuna T, Watamori K, Tsuda T, Miura H. Gender-specific difference in the recurrence of flexion contracture after total knee arthroplasty. J Exp Orthop. 2021;8(1):87.

Mannani M, Motififard M, Farajzadegan Z, Nemati A. Length of stay in patients undergoing total knee arthroplasty. J Orthop. 2022;32:121-4.

Langkilde A, Jakobsen TL, Bandholm TQ, Eugen-Olsen J, Blauenfeldt T, Petersen J, et al. Inflammation and post-operative recovery in patients undergoing total knee arthroplasty-secondary analysis of a randomized controlled trial. Osteoarthritis Cartilage. 2017;25(8):1265-73.

Levangie PK, Norkin CC, Lewek MD. Joint Structure and Function: A Comprehensive Analysis: F. A. Davis Company; 2019.

Konishi Y, Yoshii R, Ingersoll CD. Gamma Loop Dysfunction as a Possible Neurophysiological Mechanism of Arthrogenic Muscle Inhibition: A Narrative Review of the Literature. J Sport Rehabil. 2022;31(6):736-41.

Thompson R, Novikov D, Cizmic Z, Feng JE, Fideler K, Sayeed Z, et al. Arthrofibrosis After Total Knee Arthroplasty: Pathophysiology, Diagnosis, and Management. Orthop Clin North Am. 2019;50(3):269-79.

Jaleh Farahmand F, Mohammad A, Esmail Ebrahimi T, Holakoo M. Effect of McKenzie Techniques on Muscle Strengthening in Anterior Knee Pain. Journal of Modern Rehabilitation. 2018;12(1).

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IssueVol 18 No 4 (2024) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/jmr.v18i4.16912
Keywords
Total knee arthroplasty Pain Range of motion Hemorrhage Cross-sectional study

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How to Cite
1.
Farrokhi N, Akbari M, Farahini H, Saneii SH. Investigating the Correlations between Patient Demographics and Complications Following Total Knee Arthroplasty: A Cross-Sectional Study. jmr. 2024;18(4):436-442.