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Measuring Mortality after Total Knee Replacement

Total knee replacement (TKR) surgery has become a safe and commonplace procedure. However, any surgery has risks--including the risk of death. These researchers studied the death rate after TKR in more than 3,000 patients who had surgery over a period of 20 years. All the patients had TKR done by the same surgeon at the same hospital.

More than 90 percent of the patients had TKR surgery because of knee osteoarthritis. The rest of the patients had rheumatoid arthritis. Patients averaged 70 years of age. All the new knee joints were implanted using cement.

The records showed that 14 patients (0.46 percent) died within 90 days of having surgery. This equals one death for every 217 TKR surgeries. No one died in the operating room. Heart problems were the cause of death in at least six patients.

The researchers found that the death rate was much higher for older patients and those with heart problems. No differences were noted between men and women. And death rates were not changed for those who had TKR on both knees. (The doctors in this study explain that they do TKR on both knees only in younger patients and patients with lower risk factors.)

The results of this study support the current thinking that TKR is a relatively safe surgery. This type of data can help doctors decide if and when to recommend TKR for their patients.

References: Gurdev S. Gill, MD, et al. Mortality Following Primary Total Knee Arthroplasty. In The Journal of Bone and Joint Surgery. March 2003. Vol. 85-A. No. 3. Pp. 432-435.

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