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. Annals of the Rheumatic Diseases. 2014; 73(7):1316-22. [DOI:10.1136/annrheumdis-2013-204627]
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 and Cartilage. 2011; 19(11):1270-85. [DOI:10.1016/j.joca.2011.08.009] [PMID]
Arden N, Nevitt MC. Osteoarthritis: Epidemiology. Best Practice & Research. Clinical Rheumatology. 2006; 20(1):3-25. [DOI:10.1016/j.berh.2005.09.007] [PMID]
Thacoor A, Sandiford NA. Cryotherapy following total knee arthroplasty: What is the evidence? Journal of Orthopaedic Surgery. 2019; 27(1):2309499019832752. [DOI:10.1177/2309499019832752] [PMID]
Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: New insights. Part 2: Treatment approaches. Annals of Internal Medicine. 2000; 133(9):726-37. [DOI:10.7326/0003-4819-133-9-200011070-00015] [PMID]
Naylor JM, Harmer AR, Heard RC, Harris IA. Patterns of recovery following knee and hip replacement in an Australian cohort. Australian Health Review. 2009; 33(1):124-35. [DOI:10.1071/AH090124] [PMID]
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.The Journal of Bone and Joint Surgery. British volume. 2004; 86(4):561-5. [DOI:10.1302/0301-620X.86B4.14508] [PMID]
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. [DOI:10.3928/01477447-20090301-08] [PMID]
Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine. 2001; 8(12):1153-7. [DOI:10.1111/j.1553-2712.2001.tb01132.x] [PMID]
Williamson A, Hoggart B. Pain: A review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005;14(7):798-804. [DOI:10.1111/j.1365-2702.2005.01121.x] [PMID]
Hancock GE, Hepworth T, Wembridge K. Accuracy and reliability of knee goniometry methods. Journal of Experimental Orthopaedics. 2018; 5(1):46. [DOI:10.1186/s40634-018-0161-5] [PMID]
Adie S, Kwan A, Naylor JM, Harris IA, Mittal R. Cryotherapy following total knee replacement. The Cochrane Database of Systematic Reviews. 2012; (9):CD007911.[DOI:10.1002/14651858.CD007911.pub2] [PMID]
Daigle ME, Weinstein AM, Katz JN, Losina E. The cost-effectiveness of total joint arthroplasty: A systematic review of published literature. Best Practice & Research. Clinical Rheumatology. 2012; 26(5):649-58. [DOI:10.1016/j.berh.2012.07.013] [PMID]
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. The Journal of Bone and Joint Surgery. American volume. 2004; 86(5):963-74. [DOI:10.2106/00004623-200405000-00012] [PMID]
Robertsson O, W-Dahl A, Lidgren L, Sundberg M. Annual report 2015 . Gothenburg: The Swedish Knee Arthroplasty Register; 2015. [Link]
Li JW, Ma YS, Xiao LK. Postoperative pain management in total knee arthroplasty. Orthopaedic Surgery. 2019; 11(5):755-61. [DOI:10.1111/os.12535] [PMID]
Bartley EJ, Fillingim RB. Sex differences in pain: A brief review of clinical and experimental findings. British Journal of Anaesthesia. 2013; 111(1):52-8. [DOI:10.1093/bja/aet127] [PMID]
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. Journal of Experimental Orthopaedics. 2021; 8(1):87. [DOI:10.1186/s40634-021-00409-z] [PMID]
Mannani M, Motififard M, Farajzadegan Z, Nemati A. Length of stay in patients undergoing total knee arthroplasty. Journal of Orthopaedics. 2022; 32:121-4. [DOI:10.1016/j.jor.2022.05.018] [PMID]
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 and Cartilage. 2017; 25(8):1265-73. [DOI:10.1016/j.joca.2017.03.008] [PMID]
Norkin CC, Lewek MD, Levangie PK. Joint structure and function: A comprehensive analysis. Pennsylvania: F. A. Davis Company; 2019. [Link]
Konishi Y, Yoshii R, Ingersoll CD. Gamma loop dysfunction as a possible neurophysiological mechanism of arthrogenic muscle inhibition: A narrative review of the literature. Journal of Sport Rehabilitation. 2022; 31(6):736-41. [DOI:10.1123/jsr.2021-0232] [PMID]
Thompson R, Novikov D, Cizmic Z, Feng JE, Fideler K, Sayeed Z, et al. Arthrofibrosis after total knee arthroplasty: Pathophysiology, diagnosis, and management. The Orthopedic Clinics of North America. 2019; 50(3):269-79. [DOI:10.1016/j.ocl.2019.02.005] [PMID]
Farahmand Farzaneh J, Akbari M, Ebrahimi Takamjani E, Mohsenifar H. Effect of McKenzie techniques on muscle strengthening in anterior knee pain. Journal of Modern Rehabilitation. 2018; 12(1):31-8. [DOI:10.32598/jmr.12.1.31]
| Files | ||
| Issue | Vol 18 No 4 (2024) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v18i4.16912 | |
| Keywords | ||
| Total knee arthroplasty Pain Range of motion Hemorrhage Cross-sectional study | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
