RISK STRATIFICATION PROTOCOL FOR PERFORMING TOTAL KNEE ARTHROPLASTY.

Objective: the main objective of the study was to evaluate a screening protocol for performing total knee arthroplasty (TKA) without postoperative admission to an intensive care unit (ICU). The secondary objective was to evaluate the postoperative blood transfusion rate.

Method: between January 2020 and December 2021, 270 TKA were performed, following a clinical protocol: age up to 75 years, body mass index up to 35 kg/m2, ASA score classification I or II, non-smoker, without history of ischemic disease (coronary or cerebral), creatinine clearance greater than 60 mL/min, hemoglobin greater than 12 g/dL and osteoarthritis with deformity treatable with primary prosthesis (fixed or rotating base). The need for conversion to ICU and the blood transfusion rate were assessed.

Results: 270 patients underwent surgery during the study period and only one required admission to the ICU, giving the screening protocol a positive predictive value of 99.6%. There was no indication for blood transfusion in any case in the sample.

Conclusion: The proposed screening protocol proved to be effective, allowing total knee arthroplasty to be performed without the prior need for ICU bed reservation, blood typing and/or blood products reservation, without compromising patient safety. Level of Evidence IV; Case Series .