Reliability of the Clavien-Dindo classification scale for grading acute postoperative complications of total knee arthroplasty

To test the reliability of a modified Clavien-Dindo scale for grading complications following TKA (mCD-TKA) and identify risk factors for complications of varying grades. Primary TKA patients at a single institution were identified. Demographics, comorbidities, surgical time, and complications were collected. Complications were blindly graded using the mCD-TKA by two independent raters, and agreement was assessed using Cohen’s Kappa statistic. Logistic regression was used to identify risk factors for complications using odds ratios (OR). We identified 171 patients including 111 (65%) women and 60 (32%) men who underwent primary TKA. There were 56 patients (23%) with cumulative 67 complications. There were 21 Grade I complications (38%), with escalation of pain management being the most common. Grades II and III and IV comprised 20%, 38%, and 5% of all complications, respectively. Validation of the scale by two independent, blinded graders demonstrated strong inter-rater agreement (K=0.80, P