Impact of Chronic Venous Insufficiency on Outcomes After Total Knee Arthroplasty

Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis; however, postoperative complications-particularly wound healing problems-remain a significant concern. Chronic venous insufficiency (CVI) is associated with venous hypertension, impaired microcirculation, and tissue hypoxia, which may negatively affect wound healing and increase complication rates. This prospective observational cohort study aims to evaluate the impact of preoperative CVI on postoperative outcomes following TKA. Patients will be assessed preoperatively using the CEAP classification and Doppler ultrasonography to identify and stratify venous insufficiency. Participants will be followed for 12 months postoperatively. The primary outcome will be wound healing complications in the early postoperative period. Secondary outcomes will include functional outcomes assessed by the Knee Society Score (KSS), patient-reported outcomes using the WOMAC score, and overall complication rates. The findings of this study are expected to clarify the role of venous insufficiency as a potential risk factor in TKA and may contribute to improved preoperative risk stratification and postoperative management strategies.

Inclusion Criteria: * Patients undergoing primary total knee arthroplasty * Age ≥ 50 years * Ability to provide informed consent Exclusion Criteria: * Revision TKA * Peripheral arterial disease (ABI \< 0.9) * Active infection * History of deep vein thrombosis within 6 months * Immunosuppressive therapy * Severe uncontrolled diabetes mellitus