Total knee arthroplasty safe in the long run

Regardless of the urgency of the procedure, total knee arthroplasty (TKA) appears to be a safe procedure, with acceptable long-term functional outcomes and rates of limb salvage, a new study has found.

Researchers conducted a retrospective review of 58 TKA procedures, of which 27 were deemed scheduled and noncomplicated (SNC), while 31 were emergent-complicated (EC) operations. All procedures had soft-tissue flap reconstruction and were performed between 2008 and 2019. Analysis was also stratified according to infection status.

Patients were followed for a mean of 31.9 months, during which time 96.3 percent of the SNC group and 80.6 percent of the EC group achieved functional knee joint salvage. The difference was not significant (p=0.07). Similarly, transfemoral amputation occurred at comparable rates between the SNC and EC groups (3.7 percent vs 6.5 percent, respectively; p=0.36).

Both surgical urgency groups were also comparable in terms of functional outcomes, including the Oxford Knee Score (SNC vs EC: 34.5 vs 25.5; p=0.21) and range of motion (100 vs 93 degrees; p=0.37).

In contrast, infections significantly led to worse TKA outcomes. Patients who did not develop such infections saw significantly better functional knee joint salvage rates (97.1 percent vs 75.0 percent; p=0.004) and estimated five-year survival with functional knee joint (p=0.03). Transfemoral amputation rate was nearly thrice as high among infected patients though this fell short of statistical significance (8.3 percent vs 2.9 percent; p=0.36).