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Role of non-ASA VTE prophylaxis in risk for manipulation following primary total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Stiffness and decreased range of motion frequently lead to hindrance of activities of daily living and dissatisfaction follow total knee arthroplasty (TKA). This study aims to evaluate the effect of non-aspirin (ASA) chemoprophylaxis and determine patient-related risk factors for stiffness and need for manipulation under anesthesia (MUA) following primary TKA.

Materials and methods

A review of all patients undergoing primary TKA from 2013 to 2019 at a single academic orthopedic hospital was conducted. The primary outcome measure was MUA performed post-operatively. Chi-square analysis and Mann–Whitney U test were used to determine statistically significant relationships between risk factors and outcomes. Significance was set at p < 0.05. Univariate logistic regression was performed to control for identified independent risk factors for MUA.

Results

A total of 11,550 patients undergoing primary TKA from January 2013 to September 2019 at an academic medical center were included in the study. Increasing age and Charlson Comorbidity Index were associated with statistically significant decreased odds of MUA (0.93, 95% CI: 0.92–0.94, p < 0.001, OR 0.71, 95% CI 0.63–0.79, p < 0.001). Active smokers had a 2.01 increased odds of MUA (OR 2.01, 95% CI 1.28, 3.02, p < 0.001). There was no significant difference in rates of MUA between ASA and non-ASA VTE prophylaxis (p 0.108).

Conclusions

Younger age, lower CCI, and history of smoking are associated with a higher rate, while different chemical VTE prophylaxis does not influence rate of MUA after TKA. Arthroplasty surgeons should consider these risk factors when counseling patient preoperatively. Understanding each patients’ risk for MUA allows surgeons to appropriately set preoperative expectations and reasonable outcome goals.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 East 17th St, New York, NY, 10003, USA

    Noah Kirschner, Utkarsh Anil, Akash Shah & Ran Schwarzkopf

  2. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 10021, USA

    Greg Teo & William J. Long

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  1. Noah Kirschner
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  2. Utkarsh Anil
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  3. Akash Shah
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Correspondence to Noah Kirschner.

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Kirschner, N., Anil, U., Shah, A. et al. Role of non-ASA VTE prophylaxis in risk for manipulation following primary total knee arthroplasty. Arch Orthop Trauma Surg 143, 2135–2140 (2023). https://doi.org/10.1007/s00402-022-04488-0

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  • DOI: https://doi.org/10.1007/s00402-022-04488-0

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