| アブストラクト | BACKGROUND: Patients with a history of cerebrovascular disease may be at an increased risk for postoperative complications following knee arthroplasty; however, previous studies have been limited by small sample sizes and insufficient adjustment for confounding variables. This study aimed to evaluate whether cerebrovascular disease is associated with postoperative complications using a nationwide Japanese database. METHODS: A retrospective cohort study was conducted using Japan's Diagnosis Procedure Combination database from April 2016 to March 2023. Patients who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) were identified, and postoperative complications-including deep vein thrombosis, pulmonary embolism, cerebrovascular events, surgical site infection, cognitive-related complications, and periprosthetic fractures-were evaluated. Cerebrovascular disease was defined using ICD-10 codes I60-I69. Propensity score matching (1:1) was performed using demographics, comorbidities, anesthesia type, and surgical procedure. Multivariate logistic regression was conducted to account for residual confounding. RESULTS: Among 259,319 eligible patients, 8298 had cerebrovascular disease. After matching, 8269 pairs were analyzed. Before matching, patients with cerebrovascular disease showed higher rates of thromboembolic and infectious complications, longer hospital stays, and greater transfusion volume. After matching, only cognitive-related complications remained significantly more frequent in the cerebrovascular disease group. Cerebrovascular disease was associated with postoperative cognitive-related complications (odds ratio (OR) 1.70; 95% confidence interval (CI) 1.28-2.26; p = 0.0003), with a risk difference of 0.62% (95% CI 0.28-0.95). Sensitivity analyses excluding patients with preoperative dementia or cognitive impairment and analyses limited to TKA cases demonstrated directionally consistent findings, although these associations did not reach the prespecified stringent significance threshold. CONCLUSIONS: Cerebrovascular disease does not increase the risk of recurrent cerebrovascular events after knee arthroplasty; however, it elevates the risk of postoperative cognitive-related complications, despite a low absolute incidence. Although the overall incidence was low, this finding may have implications for postoperative recovery and functional outcomes. LEVEL OF EVIDENCE: III (retrospective cohort study). |
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| ジャーナル名 | Knee surgery & related research |
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| Pubmed追加日 | 2026/7/7 |
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| 投稿者 | Mori, Yu; Tarasawa, Kunio; Tanaka, Hidetatsu; Mori, Naoko; Fushimi, Kiyohide; Aizawa, Toshimi; Fujimori, Kenji |
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| 組織名 | Department of Orthopaedic Surgery, Tohoku University, Sendai, Japan.;yu.mori.c4@tohoku.ac.jp.;Department of Health Administration and Policy, Tohoku University, Sendai, Japan.;Department of Radiology, Akita University, Akita, Japan.;Department of Health Policy and Informatics, Institute of Science, Tokyo, Tokyo,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42410470/ |
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