DOS 2017

DOS Kongressen 2017 ·

Preoperative analgesic treatment and the risk of ma-

nipulation under anaesthesia (MUA) following total

knee arthroplasty (TKA) – a case-control study

Sara Svanholm, Anders Odgaard, Thomas Lind

Ortopædkirurgisk afdeling, Gentofte Hospital

Background:

Post-operative joint stiffness is a common complication to total

knee arthroplasty (TKA) and the leading cause of re-hospitalization and ma-

nipulation under anaesthesia (MUA).

Purpose / Aim of Study:

This study examines the correlation between pre-

operative analgesic treatment and the risk of post-operative MUA in order to

gain a better understanding of the risk factors associated with post-operative

joint stiffness. The goal is to identify and improve the treatment of this group

of patients.

Materials and Methods:

Design: A retrospective case-control study in which

the case population consisted of all patients receiving MUA at Gentofte Hospital

from January 2011 to December 2015. Controls were 3-4 patients receiving

TKA the same day as the TKA that led to MUA in the case group. Inclusion crite-

ria: All patients from the age of 18 and above receiving MUA following TKA as a

result of knee arthrosis, given the details regarding baseline data and analgesic

treatment were available. 101 patients undergoing MUA were included and 315

in the control group. Analysis: Analgesic treatment prior to TKA as a risk factor

was examined both univariate and adjusted. The relative risk (RR) with 95% CI

for all variables were determined through logistic regression.

Findings / Results:

Patients using analgesics prior to surgery were twice as

likely to receive MUA (RR = 2.14, p = 0,036), particularly when a combination

of Paracetamol and Ibuprofen was administered compared to no analgesic treat-

ment (RR = 2.8, p = 0.005).

Conclusions:

Analgesic treatment prior to TKA increases the risk of post-op-

erative re-manipulation and can be used as a predictor of outcome in addition

to other risk factors associated with post-operative joint stiffness. The results

could help clinicians design specialized care following TKA to improve proce-

dures and avoid re-hospitalization.

No conflicts of interest reported

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