Total Joint Arthroplasty in Patients With Atrial Septal Defects: What Are the 90-Day Complications?
Brain injury after arthroplasty surgery
Cerebrovascular accident after orthopedic surgery
Patent foramen ovale (PFO)
Stroke after arthroplasty
Transient ischemic attack after orthopedic surgery
Journal
Arthroplasty today
ISSN: 2352-3441
Titre abrégé: Arthroplast Today
Pays: United States
ID NLM: 101681808
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
04
06
2022
accepted:
08
07
2022
entrez:
29
8
2022
pubmed:
30
8
2022
medline:
30
8
2022
Statut:
epublish
Résumé
Congenital heart defects, such as atrial septal defects (ASDs) and patent foramen ovale (PFO), may increase the risk of embolic events in total hip or knee arthroplasty (THA/TKA). The objective of this study was to determine the 90-day incidence of intraoperative and postoperative embolic events and all other complications in patients with a known ASD/PFO who underwent primary hip and knee arthroplasty. This is a retrospective review of 160 patients with ASD/PFO undergoing 196 primary arthroplasties (94 THAs, 102 TKAs) at a single institution. The mean age was 64 years (standard deviation [SD] 11.1), 40.6% were male, and average body mass index was 31 kg/m There were no embolic events identified. Fourteen patients (7%) developed complications within 90 days. Three had bleeding complications, and 8 had other nonoperative complications, which were all managed conservatively and had uneventful recoveries. Additionally, 3 patients had complications requiring reoperations: 2 for periprosthetic fractures (1 THA, 1 TKA) and 1 for a periprosthetic infection (TKA). In this cohort of patients with a known ASD/PFO undergoing THAs and TKAs, there were no cases of embolic events. However, it would be advisable to have a thorough cardiology evaluation to assess potential risks and benefits of defect repair prior to total joint arthroplasty and to reduce the risk of paradoxical embolic events and the necessity of potent anticoagulation. Prognostic Level IV.
Sections du résumé
Background
UNASSIGNED
Congenital heart defects, such as atrial septal defects (ASDs) and patent foramen ovale (PFO), may increase the risk of embolic events in total hip or knee arthroplasty (THA/TKA). The objective of this study was to determine the 90-day incidence of intraoperative and postoperative embolic events and all other complications in patients with a known ASD/PFO who underwent primary hip and knee arthroplasty.
Methods
UNASSIGNED
This is a retrospective review of 160 patients with ASD/PFO undergoing 196 primary arthroplasties (94 THAs, 102 TKAs) at a single institution. The mean age was 64 years (standard deviation [SD] 11.1), 40.6% were male, and average body mass index was 31 kg/m
Results
UNASSIGNED
There were no embolic events identified. Fourteen patients (7%) developed complications within 90 days. Three had bleeding complications, and 8 had other nonoperative complications, which were all managed conservatively and had uneventful recoveries. Additionally, 3 patients had complications requiring reoperations: 2 for periprosthetic fractures (1 THA, 1 TKA) and 1 for a periprosthetic infection (TKA).
Conclusions
UNASSIGNED
In this cohort of patients with a known ASD/PFO undergoing THAs and TKAs, there were no cases of embolic events. However, it would be advisable to have a thorough cardiology evaluation to assess potential risks and benefits of defect repair prior to total joint arthroplasty and to reduce the risk of paradoxical embolic events and the necessity of potent anticoagulation.
Level of evidence
UNASSIGNED
Prognostic Level IV.
Identifiants
pubmed: 36032792
doi: 10.1016/j.artd.2022.07.005
pii: S2352-3441(22)00153-4
pmc: PMC9399375
doi:
Types de publication
Journal Article
Langues
eng
Pagination
43-46Informations de copyright
© 2022 The Authors.
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