Is it worth the risk? Frailty transition and complications following robotic total knee arthroplasty: A retrospective observational study
Frailty is an underutilized prognostic parameter in the geriatric population. Our study aimed to analyse the frailty incidence, its transition over 1 year and its influence on complication rate in patients undergoing elective robotic-assisted total knee arthroplasty (TKA). This was a retrospective s...
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| Veröffentlicht in: | The knee 2023-10, Vol.44, p.72-78 |
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| creator | Karumuri, Kishore Desai, Keyur B. Hippalgaonkar, Kushal Vecham, Ratnakar Gurava Reddy, A.V. |
| description | Frailty is an underutilized prognostic parameter in the geriatric population. Our study aimed to analyse the frailty incidence, its transition over 1 year and its influence on complication rate in patients undergoing elective robotic-assisted total knee arthroplasty (TKA).
This was a retrospective study wherein an accumulation of deficits model was used to evaluate frailty of 435 consecutive patients undergoing primary unilateral Mako-assisted cemented TKA between January 2020 and July 2021. Based upon the preoperative values, participants were divided into three groups; non-frail (FI 0.20) states and were followed up for 1 year for change in frailty class, complications, re-admissions and mortality.
A total of 435 patients were divided into three groups, non-frail (178), vulnerable (208) and frail (49). Improvement in mean frailty scores was seen in all three groups (P |
| doi_str_mv | 10.1016/j.knee.2023.07.009 |
| format | Article |
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This was a retrospective study wherein an accumulation of deficits model was used to evaluate frailty of 435 consecutive patients undergoing primary unilateral Mako-assisted cemented TKA between January 2020 and July 2021. Based upon the preoperative values, participants were divided into three groups; non-frail (FI < 0.11), vulnerable (0.11–0.20) and frail (FI > 0.20) states and were followed up for 1 year for change in frailty class, complications, re-admissions and mortality.
A total of 435 patients were divided into three groups, non-frail (178), vulnerable (208) and frail (49). Improvement in mean frailty scores was seen in all three groups (P < 0.0001); 21.63% of the vulnerable and 48.97% of the frail participants improved by one frailty class. Multivariate analysis showed the co-relation of change in frailty index (ΔFI) with preoperative FI (r = 0.083) and Knee Society Score (KSS) (r = 0.742). The frail group had a significantly higher re-admission rate over 1 year. When compared with the vulnerable group, the frail group had a higher hazard ratio for readmission (3.12 vs. 0.96) and complications (1.62 vs. 1.26).
Although frail individuals are at a higher risk for readmissions and perioperative complications, TKA significantly improves the mobility and frailty status of elderly individuals. With explained higher risk of complications, surgeons should not refrain from offering TKA to elderly frail individuals disabled with knee pain.</description><identifier>ISSN: 0968-0160</identifier><identifier>EISSN: 1873-5800</identifier><identifier>DOI: 10.1016/j.knee.2023.07.009</identifier><identifier>PMID: 37536072</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Accumulation of deficits ; Elderly arthroplasty ; Frailty index ; Total joint arthroplasty ; Total knee arthroplasty</subject><ispartof>The knee, 2023-10, Vol.44, p.72-78</ispartof><rights>2023 Elsevier B.V.</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-1e82884456f946ff20c31f2a7bf023c879dfb123b61ef45793a610a5a49507173</cites><orcidid>0000-0002-1541-923X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.knee.2023.07.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37536072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karumuri, Kishore</creatorcontrib><creatorcontrib>Desai, Keyur B.</creatorcontrib><creatorcontrib>Hippalgaonkar, Kushal</creatorcontrib><creatorcontrib>Vecham, Ratnakar</creatorcontrib><creatorcontrib>Gurava Reddy, A.V.</creatorcontrib><title>Is it worth the risk? Frailty transition and complications following robotic total knee arthroplasty: A retrospective observational study</title><title>The knee</title><addtitle>Knee</addtitle><description>Frailty is an underutilized prognostic parameter in the geriatric population. Our study aimed to analyse the frailty incidence, its transition over 1 year and its influence on complication rate in patients undergoing elective robotic-assisted total knee arthroplasty (TKA).
This was a retrospective study wherein an accumulation of deficits model was used to evaluate frailty of 435 consecutive patients undergoing primary unilateral Mako-assisted cemented TKA between January 2020 and July 2021. Based upon the preoperative values, participants were divided into three groups; non-frail (FI < 0.11), vulnerable (0.11–0.20) and frail (FI > 0.20) states and were followed up for 1 year for change in frailty class, complications, re-admissions and mortality.
A total of 435 patients were divided into three groups, non-frail (178), vulnerable (208) and frail (49). Improvement in mean frailty scores was seen in all three groups (P < 0.0001); 21.63% of the vulnerable and 48.97% of the frail participants improved by one frailty class. Multivariate analysis showed the co-relation of change in frailty index (ΔFI) with preoperative FI (r = 0.083) and Knee Society Score (KSS) (r = 0.742). The frail group had a significantly higher re-admission rate over 1 year. When compared with the vulnerable group, the frail group had a higher hazard ratio for readmission (3.12 vs. 0.96) and complications (1.62 vs. 1.26).
Although frail individuals are at a higher risk for readmissions and perioperative complications, TKA significantly improves the mobility and frailty status of elderly individuals. With explained higher risk of complications, surgeons should not refrain from offering TKA to elderly frail individuals disabled with knee pain.</description><subject>Accumulation of deficits</subject><subject>Elderly arthroplasty</subject><subject>Frailty index</subject><subject>Total joint arthroplasty</subject><subject>Total knee arthroplasty</subject><issn>0968-0160</issn><issn>1873-5800</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kUFv1DAQhS0EokvhD3BAPnJJOnYSO0FIqKoorVSJC5wtxxlTb71xsL1b7U_gX-OwhSOnkUbfe5p5j5C3DGoGTFxs64cZsebAmxpkDTA8IxvWy6bqeoDnZAOD6KtCwhl5ldIWAMTQdi_JWSO7RoDkG_LrNlGX6WOI-Z7me6TRpYdP9Dpq5_OR5qjn5LILM9XzRE3YLd4ZvS4StcH78OjmHzSGMWRnaA5Ze7peRXUxjGHxOuXjB3pJI-YY0oImuwPSMCaMhz8-RZDyfjq-Ji-s9gnfPM1z8v3687erm-ru65fbq8u7yjQgc8Ww533ftp2wQyus5WAaZrmWoy05mF4Okx0Zb0bB0LadHBotGOhOt0MHksnmnLw_-S4x_NxjymrnkkHv9YxhnxTvWzHwrm-HgvITasrpKaJVS3Q7HY-KgVorUFu1PqvWChRIVSooondP_vtxh9M_yd_MC_DxBGD58uAwqmQczgYnF0s8agruf_6_AX2rmm4</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Karumuri, Kishore</creator><creator>Desai, Keyur B.</creator><creator>Hippalgaonkar, Kushal</creator><creator>Vecham, Ratnakar</creator><creator>Gurava Reddy, A.V.</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1541-923X</orcidid></search><sort><creationdate>20231001</creationdate><title>Is it worth the risk? Frailty transition and complications following robotic total knee arthroplasty: A retrospective observational study</title><author>Karumuri, Kishore ; Desai, Keyur B. ; Hippalgaonkar, Kushal ; Vecham, Ratnakar ; Gurava Reddy, A.V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-1e82884456f946ff20c31f2a7bf023c879dfb123b61ef45793a610a5a49507173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accumulation of deficits</topic><topic>Elderly arthroplasty</topic><topic>Frailty index</topic><topic>Total joint arthroplasty</topic><topic>Total knee arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karumuri, Kishore</creatorcontrib><creatorcontrib>Desai, Keyur B.</creatorcontrib><creatorcontrib>Hippalgaonkar, Kushal</creatorcontrib><creatorcontrib>Vecham, Ratnakar</creatorcontrib><creatorcontrib>Gurava Reddy, A.V.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The knee</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karumuri, Kishore</au><au>Desai, Keyur B.</au><au>Hippalgaonkar, Kushal</au><au>Vecham, Ratnakar</au><au>Gurava Reddy, A.V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is it worth the risk? Frailty transition and complications following robotic total knee arthroplasty: A retrospective observational study</atitle><jtitle>The knee</jtitle><addtitle>Knee</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>44</volume><spage>72</spage><epage>78</epage><pages>72-78</pages><issn>0968-0160</issn><eissn>1873-5800</eissn><abstract>Frailty is an underutilized prognostic parameter in the geriatric population. Our study aimed to analyse the frailty incidence, its transition over 1 year and its influence on complication rate in patients undergoing elective robotic-assisted total knee arthroplasty (TKA).
This was a retrospective study wherein an accumulation of deficits model was used to evaluate frailty of 435 consecutive patients undergoing primary unilateral Mako-assisted cemented TKA between January 2020 and July 2021. Based upon the preoperative values, participants were divided into three groups; non-frail (FI < 0.11), vulnerable (0.11–0.20) and frail (FI > 0.20) states and were followed up for 1 year for change in frailty class, complications, re-admissions and mortality.
A total of 435 patients were divided into three groups, non-frail (178), vulnerable (208) and frail (49). Improvement in mean frailty scores was seen in all three groups (P < 0.0001); 21.63% of the vulnerable and 48.97% of the frail participants improved by one frailty class. Multivariate analysis showed the co-relation of change in frailty index (ΔFI) with preoperative FI (r = 0.083) and Knee Society Score (KSS) (r = 0.742). The frail group had a significantly higher re-admission rate over 1 year. When compared with the vulnerable group, the frail group had a higher hazard ratio for readmission (3.12 vs. 0.96) and complications (1.62 vs. 1.26).
Although frail individuals are at a higher risk for readmissions and perioperative complications, TKA significantly improves the mobility and frailty status of elderly individuals. With explained higher risk of complications, surgeons should not refrain from offering TKA to elderly frail individuals disabled with knee pain.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37536072</pmid><doi>10.1016/j.knee.2023.07.009</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1541-923X</orcidid></addata></record> |
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| source | Access via ScienceDirect (Elsevier) |
| subjects | Accumulation of deficits Elderly arthroplasty Frailty index Total joint arthroplasty Total knee arthroplasty |
| title | Is it worth the risk? Frailty transition and complications following robotic total knee arthroplasty: A retrospective observational study |
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