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. 2023 Dec 17;12(24):7734.
doi: 10.3390/jcm12247734.

Arterial Stiffness, Assessed Using the Cardio-Ankle Vascular Index, before and 2 Years after Total Knee Arthroplasty in Patients with Knee Osteoarthritis

Yoshinori Ishii  1 , Hideo Noguchi  1 , Junko Sato  1 , Ikuko Takahashi  1 , Hana Ishii  2 , Ryo Ishii  3 , Kei Ishii  4 , Kai Ishii  5 , Shin-Ichi Toyabe  6
Affiliations

Arterial Stiffness, Assessed Using the Cardio-Ankle Vascular Index, before and 2 Years after Total Knee Arthroplasty in Patients with Knee Osteoarthritis

Yoshinori Ishii et al. J Clin Med. .

Abstract

Purpose: Cardiovascular disease (CVD) is a major risk factor for mortality in patients with osteoarthritis, and such comorbidities increase the risk of postoperative complications following total knee arthroplasty (TKA). Arteriosclerosis plays a major role in hemodynamic dysfunction and CVD; however, the postoperative changes in arteriosclerosis following TKA have not been evaluated. Therefore, we assessed the postoperative changes in arteriosclerosis using the cardio-ankle vascular index (CAVI) in patients undergoing TKA, and its relationships with preoperative patient characteristics. Methods: Arteriosclerosis was prospectively evaluated in 119 consecutive patients (140 knees) (15 males (17), 104 females (123); median age 73 years) with knee osteoarthritis who underwent TKA. CAVI was measured before and 2 years after TKA, and the relationships between CAVI and preoperative age, sex, BMI, physical activity status, comorbidities, clinical score, triglyceride concentration, cholesterol concentration, and smoking history were analyzed. Results: CAVI remained stable or improved in 54 joints (39%) and worsened in 86 joints (61%) 2 years post-operation. The median difference between pre- and postoperative CAVI was 0.2 (-0.3, 0.8), and the only preoperative factor associated with this change was preoperative CAVI (r = -0.469, p < 0.001). No other preoperative factor had a significant effect on postoperative arteriosclerosis. Conclusions: The results suggest that patients who undergo TKA subsequently show less severe arteriosclerosis, and the protective effect of TKA on arterial stiffness is greater in those with a higher preoperative CAVI. TKA may be an effective means of reducing the deterioration of arteriosclerosis associated with knee osteoarthritis, at least in the relatively short term.

Keywords: arteriosclerosis; cardio–ankle vascular index; knee osteoarthritis; total knee arthroplasty.

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Conflict of interest statement

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1
Figure 1
Measurement of cardio–ankle vascular index (CAVI) 2 years following a right-side total knee arthroplasty in a 77-year-old woman. First, the distance from the origin of the aorta to the ankle was measured with the patient lying supine on a bed. Next, cuffs were wrapped around the right and left upper arms and the right and left ankle joints to measure blood pressure, and a microphone that detects heart sounds was attached to the chest. The instrument automatically measured the pulse wave and blood pressure and calculated CAVI. The entire measurement took ~15 min and was painless.
Figure 2
Figure 2
Scatter plot of the change in CAVI (postoperative − preoperative CAVI) versus preoperative CAVI. CAVI, cardio–ankle vascular index.
Figure 3
Figure 3
Scatter plot of the change in CAVI (postoperative − preoperative CAVI) versus postoperative CAVI. CAVI, cardio–ankle vascular index.
See this image and copyright information in PMC

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