Abstract
We devised a four-part clinical risk classification system for patients undergoing primary total knee arthroplasty (PTKR) to facilitate risk estimation. We retrospectively reviewed a series of consecutive PTKRs performed by the senior author. A classification system was devised to take account of principal risk factors in PTKR (Table 1). The patients were grouped accordingly, and the following were compared:
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Length of stay
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Postoperative complications
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Early post discharge follow-up assessment
Multiple regression analysis was performed. This revealed:
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Similar complication rates in the NCP and CPI groups.
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3-fold and 4-fold increase in the cumulative risk in the CPII, and CPIII groups respectively (p< 0.001)
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Increased length of stay in the CPIII group (p< 0.001).
Conclusion: This classification correlates well with complication rates from surgery, and has a role in stratifying patients for preoperative planning and risk counselling. It is reproducible and can be used for larger patient groups via the National Joint Registry. Our findings also have implications for payment by results and fixed tariffs for PTKR.
Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
