Data Collection
Information on patient demographic including age, gender, body mass
index (BMI), and whether unilateral or bilateral TKA was performed was
recorded based on patient perioperative medication treatment group and
used to assess possible discrepancy between groups (Table 1 & 2). Data
was then collected for each treatment group evaluating pre- and
post-operative metrics of joint function, surgical parameters, and
bloodwork.
Preoperative
Preoperative knee status was determined using Hospital of Special
Surgery (HSS) total knee score, a standardized 100-point approach to TKA
assessment that includes joint range of motion (ROM), joint function,
and pain. Pain was further assessed using a Visual Analog Scale (VAS).
Baseline blood work was recorded measuring white blood cells (WBC),
hemoglobin (HGB), C reaction protein (CRP), erythrocyte sedimentation
rate (ESR), and rheumatoid factor (RF). Additionally, choice of
anesthesia was also recorded for each surgery.
Postoperative
HSS score, joint function, pain and VAS score were all assessed at time
of latest follow-up. While ROM was measured twice, shortly postoperative
prior to patient discharge and again during follow-up. Evaluation of
postoperative management also included volume of wound drainage,
postoperative temperature at days one and three (T pod 1 and 3), need
for postoperative blood transfusion, volume of blood transfusion, and
bloodwork measuring WBC, HGB and HGB drop during surgery (calculated by
subtracting postoperative HGB from preoperative HGB). Patients were
monitored for 3 months postoperatively for incidence of deep vein
thrombosis (DVT) and short-term complications such as acute infection,
delayed wound healing, need for blood transfusion, RA flare, etc., which
were categorized into: systematic, wound, and surgical issues. Long term
follow-up was performed approximately 10 years after TKA to document all
complications that may have resulted from the operation, including
periprosthetic joint infection (PJI), fracture, prosthesis loosening and
need for surgical revision.
Of note, HSS score and ROM were evaluated separately for each knee in
patients undergoing bilateral TKA, while other parameters such as pain
were assessed jointly to better reflect overall patient disease status.