Aladen Nizar Mohammed AbuharfielRoyal Commission Medical Center, KSA
Title: Comprehensive evidence-based selection criteria in hip and knee arthroplasty. Better outcomes and fewer complications
Background: The demands for Total Joint Arthroplasty/TJA are increasing due to increasing levels of aging populations, joint injuries, and physically active life styles. Although TJA surgery is considered as a successful and effective solution for people suffering of severe joint arthritis, some rarely occurring complications can be catastrophic like Periprosthetic
Joint Infection PJI. Some parameters were separately well studied in the literature as risk factors associated with higher complication rates and worse outcome after TJA. This is a thorough literature review to gather those risk factors to form what can be accepted as a comprehensive selection criteria associated with higher complications rates after TJA. Implementation of such selection criteria is likely to significantly reduce the complication rates and improve the functional outcome following elective TJA.
Method: A thorough literature review has been conducted to gather the main risk factors associated with higher complication rates after joint arthroplasty and to find out how badly each risk factor can affect the outcome. The best cutoff points for some of these risk factors were set in this review based on a group of studies and guidelines to finally form
what can be a clear selection criteria for arthroplasty surgery although there is no consensus.
Results: 12 risk factors were selected and included in this review as selection criteria as they were found to be significantly associated with higher complication rates especially Periprosthetic Joint Infection. Anemia, hypertension, hyperglycemia, malnutrition, morbid obesity and smoking are amongst those selection criteria.
Conclusion: Routine implementation of such selection criteria as a package is likely to significantly reduce the complication rates and improve the functional outcome following elective TJA. Further randomized controlled studies are needed to confirm this assumption and to set clear cut off points for these criteria.
Aladen Nizar,MD is a consultant orthopedic surgeon at Royal Commission Medical Center in Yanbu/ Saudi Arabia certified in the subspecialty of sport surgery, arthroscopy and arthroplasty.MBBS degree in 2006, Jordanian board 2012. Italian fellowship from Istituto Ortopedico Rizzoli in Bologna 2017. Australian fellowship from St.Vincent’s SportsMed in Sydney 2018. Active member of ISAKOS. Published a couple of articles in Arthroplasty and ACL reconstruction.