Beta-blocker prophylaxis for total knee arthroplasty patients: a case series.


Journal Article

Cardiac complications are an infrequent yet undesirable cause of morbidity and mortality following total knee arthroplasty. Perioperative prophylaxis with beta-blocker medication has been shown to reduce in-hospital cardiac deaths in noncardiac surgical patients. This study evaluated the safety and in-hospital cardiac complications of a consecutive cohort of 267 total knee arthroplasties in patients who followed a perioperative beta-blocker prophylaxis institutional protocol. The patients were categorized into three groups: A, already on a beta-blocker; B, beta-blocker prescribed by orthopaedic surgeon; and C, not given the medication. The 90-day mortality and in-hospital cardiac complications were evaluated. Of the patients who had 267 procedures, 203 (76%) received beta-blocker prophylaxis perioperatively: 110 (41.2%) were already on the medication preoperatively, 93 (34.8%) were prescribed the medication by the surgeon, and 64 (24%) did not receive this medication. There were no deaths within the first 90 days. There were two nonfatal myocardial infarctions (0.7%) and six other cardiac complications (2.2%). With a beta-blocker prophylaxis protocol implemented by one surgeon, 76% of total knee arthroplasty patients were given the medication and it was prescribed in 34.8% by the orthopaedic surgeon. In-hospital cardiac complications were low.

Full Text

Duke Authors

Cited Authors

  • Heim, KA; Lachiewicz, MP; Soileau, ES; Lachiewicz, PF

Published Date

  • 2010

Published In

Volume / Issue

  • 19 / 3

Start / End Page

  • 162 - 165

PubMed ID

  • 21086929

Pubmed Central ID

  • 21086929

International Standard Serial Number (ISSN)

  • 1548-825X


  • eng

Conference Location

  • United States