Acta orthopaedica
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Multicenter Study Observational Study
Myocardial infarction following fast-track total hip and knee arthroplasty-incidence, time course, and risk factors: a prospective cohort study of 24,862 procedures.
Background and purpose - Acute myocardial infarction (MI) is a leading cause of mortality following total hip and knee arthroplasty (THA/TKA). The reported 30-day incidence of MI varies from 0.3% to 0.9%. However, most data derive from administration and insurance databases or large RCTs with potential confounding factors. ⋯ Interpretation - Fast-track THA and TKA had a low 30-day MI incidence. Focus on patients with age >85, IDDM, cardiovascular disease, and hypercholesterolemia may further reduce the 30-day incidence of MI. The role of postoperative anemia and intraoperative hypotension are other areas for further improvement.