J Knee Surg 2021; 34(03): 322-327
DOI: 10.1055/s-0039-1695766
Original Article

Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complications Following Simultaneous Bilateral Total Knee Arthroplasty

Alex Gu
1   Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York
2   George Washington School of Medicine and Health Sciences, Washington, District of Columbia
,
Shitong Wu
3   Department of Biology, Duke University, Durham, North Carolina
,
Fabio Mancino
4   Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Jiabin Liu
5   Department of Anesthesiology, Hospital for Special Surgery, New York, New York
,
Michael P. Ast
6   Adult Reconstruction and Joint Service, Hospital for Special Surgery, New York, New York
,
Matthew P. Abdel
7   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Peter K. Sculco
1   Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York
› Author Affiliations

Abstract

For patients who qualify, simultaneous bilateral total knee arthroplasty (TKA) is a viable option for the treatment of bilateral symptoms. However, the incidence of chronic obstructive pulmonary disease (COPD) has been steadily rising over the past few decades and may impact those who qualify as candidates for bilateral TKA. As such, the aim of this study was to determine the impact of COPD on postoperative outcomes in patients who receive simultaneous bilateral TKA. A retrospective cohort study was conducted utilizing data provided through the American College of Surgeons National Surgical Quality Improvement Program. All patients who had undergone simultaneous bilateral TKA between 2007 and 2016 were identified and further stratified into groups based upon the COPD status. Incidence of adverse events after TKA in the acute postoperative period was evaluated with univariate and multivariate analyses. COPD was found to be an independent risk factor for the development of major (odds ratio [OR]: 2.5; p = 0.015), renal (OR: 5.1; p = 0.02), and thromboembolic complications (OR: 2.5; p = 0.027). In addition, patients with COPD were at increased risk for having an extended hospital length of stay (LOS; p < 0.001) and development of urinary tract infections (p < 0.001). Patients with COPD are at higher risk for development of overall major complications, as well as renal and thromboembolic complications after simultaneous bilateral TKA. Interestingly, patients were not at increased risk for the development of pulmonary or wound complications. When considering a staged versus simultaneous bilateral TKA, surgeons should be aware of the impact COPD status has on the postoperative complication rate.



Publication History

Received: 06 November 2018

Accepted: 15 July 2019

Article published online:
30 August 2019

© 2019. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
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