Intensive care needs after hip and knee replacement: understanding risk profiles for severe postoperative…

Cohort studyJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology· Jul 2025

Intensive care needs after hip and knee replacement: understanding risk profiles for severe postoperative complications.

Dominik Emanuel Holzapfel, Tobias Kappenschneider, Sabrina Holzapfel … Timo Schwarz

Read paper

Perioperative MedicineCohort studyPrognosisQ1IF 4.5

Anticoagulant use linked to higher odds of intensive care unit transfer after joint replacement.

Intensive care needs after hip and knee replacement: understanding risk profiles for severe postoperative complications.

Dominik Emanuel Holzapfel … Timo Schwarz

Journal of orthopaedics and traumatology · Jul 2025 · Q1 in General Medicine

Background

The etiology of serious life-threatening events after total joint arthroplasty (total joint arthroplasty) is poorly elaborated and understood in literature.

Purpose

The purpose of this study was to identify independent predictors of postoperative intensive care following total hip arthroplasty (total hip arthroplasty) and total knee arthroplasty (total knee arthroplasty) and to clarify the circumstances leading to these transfers.

Methods

A total of 142 patients suffering from postoperative intensive care-dependent serious adverse events (Clavien-Dindo classification Grade IV, CD°IV) after total hip arthroplasty or total knee arthroplasty were matched 1:1 with non-CD°IV patients using propensity score matching for age, sex, comorbidity (Charlson Comorbidity Index, CCI), and year of treatment.

n = 142 patients

Results

anticoagulant use nearly triples odds of intensive care unit transfer after joint replacement

OR by subgroup · 95% CI

“

Conclusion · 1 of 3

Patients with CD°IV events after total hip arthroplasty and total knee arthroplasty represent a complex, vulnerable, and multimorbid patient population.

Conclusion · 2 of 3

There is a need for a multidisciplinary approach that integrates prehabilitation and perioperative risk assessments to reduce the occurrence of severe, life-threatening events requiring intensive care unit care.

Conclusion · 3 of 3

LEVEL OF EVIDENCE: Level III-retrospective cohort study.

Intensive care needs after hip and knee replacement: understanding risk profiles for severe postoperative complications.

Intensive care needs after hip and knee replacement: understanding risk profiles for severe postoperative complications.

Related papers