Research on outcomes for joint replacement surgery has led to targeted patient selection for Total Knee Replacement surgery. Risk factors for poor outcomes include obesity, uncontrolled diabetes, smoking and cardiovascular disease. Great emphasis has been placed on modifying risk factors PRIOR to knee replacement surgery. Many patients are willing undergo an intervention which lowers their chance for an adverse outcome. It appears that this approach is benefitting our patients.
There is an ongoing worldwide temporal decline in mortality following total knee arthroplasty. Improved patient selection and perioperative care and a healthy-population effect may account for this observation. Efforts to further reduce mortality following total knee arthroplasty should continue. Patients that are unable to be “optimized” should be offered alternative, non surgical treatments.
An article published in JBJS June, 2018 explored this topic.
Mortality data from 15 different countries following over 1.75 million total knee replacements formed the basis of this review. 30 and 90-day mortality were 0.20% and 0.39%. Both estimates have fallen over the 10-year study period.