Predictive value of lower extremity colored doppler ultrasonography on postoperative cardiovascular event before knee arthroplasty surgery

The aim of the present study is to determine the correlation of preoperative lower extremity arterial color Doppler ultrasonography (CDUS) and lower extremity arterial calcification (LEAC) with cardiovascular event (CVE) in the perioperative and postoperative periods in population of patients undergoing total knee arthroplasty (TKA) and to examine its effect on surgical risk estimation. Of the 853 patients, who had been operated for primary gonarthrosis between January 2005 and December 2015, 467, who were administered preoperative Doppler ultrasonography and met inclusion criteria, were retrospectively reviewed for their medical records. The patients with AC made up the study group, while the rest constituted the control group. The patients were evaluated according to age, gender, BMI, the presence of calcification on roentgenography, any preoperative and postoperative cardiovascular diagnosis - especially ischemic heart disease, valvular heart disease, cardiac dysrhythmia, congestive heart failure (CHF), coronary artery bypass grafting, hypertension, DM, lipid disorder, peripheral arterial disease (PAD), and ASA scores. The proportion of the male population, the presence of AC on preoperative roentgenography, preoperative CHF, and the number of patients with PAD was statistically higher in the study group. The incidence of ischemic heart disease, including perioperative and postoperative MI was higher in the study group than the control group. Also, the perioperative and postoperative dysrhythmia and CHF were higher in the control group compared to the study group. The assessment of mortality indicated that more patients were lost due to cardiovascular causes in the study group; however, no statistically significant difference was found between the two groups. When all the findings of the study were evaluated, the presence of AC on CDU was found to be associated with increased risk for perioperative and postoperative cardiovascular events. In this context, the presence of AC on ultrasonography may contribute to the physicians to do a risk evaluation in terms of CVEs likely to develop perioperatively and postoperatively.