-transparent.png){kind=logo}
OBJECTIVE Lower extremity arterial injury is a rare complication following total knee (TKA) or total hip arthroplasty (THA). To date, no multi-institutional study has identified preoperative factors that may portend increased risk for these injuries. We queried a large clinical database for the incidence and predictors of arterial injury and/or compromise following lower extremity arthroplasty. METHODS Prospectively collected preoperative and postoperative data by the National Surgical Quality Improvement Program (NSQIP) of the Veterans Affairs Medical Centers were analyzed. All patients from 1996 to 2003 in the NSQIP database who underwent TKA or THA were identified via CPT codes. NSQIP defined, 30-day, postoperative outcomes were analyzed. Data were compared using bivariable analysis, as well as limited multivariable logistic regression. RESULTS A total of 41,633 arthroplasties (24,029 TKA, 2077 redo-TKA, 13,494 THA, 2033 redo-THA) were identified in the NSQIP database. A total of 34 (0.08%) lower extremity arterial injuries were recognized (0.08% TKA, 0.19% redo-TKA, 0.04% THA, 0.20% redo-THA). Eighteen injuries were repaired on the same day of surgery (seven intraop, 11 postop), eight between postoperative days 1 and 5, and 8 between days 6 and 30. Only two patients underwent lower extremity amputation (overall limb loss rate of 5.9% of patients who had arterial injury). Statistically significant predictors of lower extremity arterial injury identified on logistic regression analysis included redo procedure (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.2-6.0, P = .013) and African American race (OR 2.5, 95% CI 1.2-5.3, P = .02). CONCLUSIONS Lower extremity arterial injury was exceedingly rare after total knee or total hip arthroplasty. There is an increased incidence in African American patients and those undergoing redo arthroplasty. Among patients who sustain vascular injury, excellent limb salvage rates can be achieved with close postoperative surveillance to achieve early detection and repair of injuries.
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
May 2015,
Orthopedics,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
July 2022,
BMJ military health,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
January 2020,
Journal of orthopaedic surgery (Hong Kong),
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
January 2003,
International orthopaedics,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
December 2005,
Journal of biomechanics,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
December 1997,
Clinical orthopaedics and related research,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
June 2015,
The Journal of bone and joint surgery. American volume,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
February 2011,
The American journal of managed care,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
December 2010,
The Journal of arthroplasty,
Christopher J Abularrage, and
Jonathan M Weiswasser, and
Kent J Dezee, and
Mark B Slidell, and
William G Henderson, and
Anton N Sidawy
June 2016,
Pain,
