Evidence map›Paper›PMID 36773661›Full record

ArticleThe Journal of arthroplasty2023

Spinal Versus General Anesthesia in Contemporary Revision Total Knee Arthroplasties.

Aaron R Owen, Adam W Amundson, Dirk R Larson, Christopher M Duncan, Hugh M Smith, Rebecca L Johnson, Michael J Taunton, Mark W Pagnano, Daniel J Berry, Matthew P Abdel

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of arthroplasty, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
3.2field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Aaron R OwenDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Adam W AmundsonDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Dirk R LarsonDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
Christopher M DuncanDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Hugh M SmithDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Rebecca L JohnsonDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Michael J TauntonDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Mark W PagnanoDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Daniel J BerryDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Matthew P AbdelDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Mayo Clinic · USMayo Clinic in Florida · US

Funding

Resource CoreP30AR076312 · NIAMS · MAYO CLINIC ROCHESTER · PI Daniel Berry · 2019 to 2026
$5.5M
Precision Orthopedics: Multimodal Data Infrastructure for Personalized Surgical Decisions in Joint ArthroplastyR01AR073147 · NIAMS · MAYO CLINIC ROCHESTER · PI Hilal Maradit Kremers · 2018 to 2026
$3.5M
Cardiotoxicity in Total Joint ArthroplastyR01HL147155 · NHLBI · MAYO CLINIC ROCHESTER · PI MARADIT KREMERS, HILAL · 2019 to 2022
$2.8M
NHLBI NIH HHS R01 HL147155NIAMS NIH HHS P30 AR076312NIAMS NIH HHS R01 AR073147
6 · The paper itself

Abstract

backgroundInterest in spinal anesthesia utilization in revision total knee arthroplasties (TKAs) is rising. This study investigated the pain control, length of stay (LOS), and complications associated with spinal versus general anesthesia in a single institution series of revision TKAs.

methodsWe identified 3,711 revision TKAs (3,495 patients) from 2001 to 2016 using our institutional total joint registry. There were 66% who had general anesthesia and 34% who had spinal anesthesia. Mean age, sex, and BMI were similar between groups at 67 years, 53% women, and 32, respectively. Data were analyzed using inverse probability of treatment weighted models based on propensity scores that accounted for patient and operative factors. Mean follow-up was 6 years (range, 2 to 17).

resultsPatients treated with spinal anesthesia required fewer postoperative oral morphine equivalents (OMEs) (P < .0001) and had lower numeric pain rating scale scores (P < .001). Spinal anesthesia was associated with shorter LOS (4.0 versus 4.6 days; P < .0001), less cases of altered mental status (AMS; Odds Ratio (OR) 2.0, P = .004), less intensive care unit (ICU) admissions (OR 1.6, P = .02), fewer re-revisions (OR 1.7, P < .001), and less reoperations (OR 1.4, P < .001). There was no difference in the incidence of VTE (P = .82), 30-day readmissions (P = .06), or 90-day readmissions (P = .18) between anesthetic techniques.

conclusionWe found that spinal anesthesia for revision TKAs was associated with significantly lower pain scores, reduced OME requirements, and decreased LOS. Furthermore, spinal anesthesia was associated with fewer cases of AMS, ICU admissions, and re-revisions even after accounting for numerous patient and operative factors. LEVEL OF EVIDENCE: Level III, Retrospective Comparative Study.

Indexed as

Anesthesia, SpinalArthroplasty, Replacement, KneeAgedAnesthesia, GeneralFemaleHumansMalePainReoperationRetrospective Studiesneuraxial anesthesiaopioidspainrevisiontotal joint arthroplasty

Identifiers

PMID36773661
PMCPMC10433444
OpenAlexW4319663199

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.