title: Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors.
abstract: BACKGROUND
  Although vascular disease is commonly accepted as a risk factor for wound complications and prosthetic joint infections, little is known about the preoperative prevalence of lower-extremity peripheral vascular disease in patients undergoing total knee arthroplasty (TKA). In this study, we investigated the prevalence of asymptomatic vascular disease and its risk factors.
  
  
  METHODS
  A total of 1,000 knees of 692 patients who underwent primary TKA due to osteoarthritis were preoperatively evaluated by experienced musculoskeletal radiologists using Doppler ultrasonography of the lower extremity vessels. The mean age of the patients was 74.1 years (range 65-81). Risk factors for development of peripheral vascular disease were investigated.
  
  
  RESULTS
  Abnormal findings were identified in 38 knees of 32 patients (4.6 %); atherosclerotic changes in 31 knees of 25 patients (3.6 %), deep vein thrombosis (DVT) in two knees, and anomalous vessels in five knees. Three out of 31 knees with atherosclerotic changes showed severe luminal stenosis. Two knees were moderate and 26 knees showed mild changes according to our institutional criteria. Multivariate logistic regression analysis showed that age and diabetes mellitus were positively associated with vascular pathology.
  
  
  CONCLUSIONS
  The prevalence of incidentally detected peripheral vascular disease was significant. Three of 31 knees had severe arterial stenosis and two knees had DVT. All patients with vascular pathologies had one or more risk factors related to vascular disease. Out of those patients, age was the most important risk factor. Understanding the prevalence of vascular pathology and related risk factors in TKA candidates may be important for successful TKA.
  
  
  METHODS
  Level III.
authors.affiliation: Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 20-8, Songpa-dong, Songpa-gu, Seoul, Korea.
authors.forename: Ill Ho
authors.initials: IH
authors.lastname: Park
authors.forename: Su Chan
authors.initials: SC
authors.lastname: Lee
authors.forename: Il Seok
authors.initials: IS
authors.lastname: Park
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Nam
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Ahn
authors.forename: Ha Young
authors.initials: HY
authors.lastname: Park
authors.forename: Viralkumar Harilal
authors.initials: VH
authors.lastname: Gondalia
authors.forename: Kwang Am
authors.initials: KA
authors.lastname: Jung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications* / Q000601:surgery; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D057234:Preoperative Period; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D018608:Ultrasonography, Doppler
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