Background: Stiffness is a known complication following total knee arthroplasty. Multiple options are available to address this problem but revision TKA has been reported to be an effective treatment especially in the presence of technical issues such as oversized or loose components. However, it is not clearly known what factors may affect the outcome of revision TKA for stiffness. The purpose of this study was to evaluate the results of TKA revision for stiffness and to determine which potential factors may predict the outcome.
Materials And Methods: Between 1999 and 2006, 39 patients (24 females and 15 males) were revised for stiffness following their primary TKA. The average age was 60.8 years with an average BMI of 30.7. The mean follow up was 74.4 months.
Results: Following revision TKA, the overall range of motion and flexion contracture improved significantly from 68 to 90 (p=0.001) and from 14 to 5 (p<0.0001), respectively. Although the KSS were significantly improved from 45.72 to 77.10 (p<0.0001), the functional score did not improve significantly. Of the 39 knees which had stiffness, 10 (25.6%) required a second revision. We could not find any demographic or operative characteristics as a predictor failure.
Conclusion: Our study shows that TKA revision is a viable option, still unpredictable, to improve the ROM in patients with prolonged stiffness after TKA. Although revision for stiffness is not always successful in terms of achieving functional range of motion, it could improve pain in presence of less than functional range of motion.
Level Of Evidence: Prognostic Level II.
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http://dx.doi.org/10.1016/j.knee.2011.06.016 | DOI Listing |
Knee Surg Relat Res
January 2025
Department of Orthopedics, Seoul National University College of Medicine, Seoul, South Korea.
Introduction: Prosthetic joint infection (PJI) is one of the most common and detrimental complications of total knee replacement arthroplasty (TKA). Despite extensive efforts, including two-stage reimplantation, to eradicate PJI, it still recurs in a substantial number of patients. However, the risk factors of recurrence after two-stage reimplantation of the knee have not been established.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
January 2025
From the Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Lim, Sayeed, Bedair, and Melnic), and the Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA (Lim, Sayeed, Bedair, and Melnic).
Introduction: Multiple sclerosis (MS) may negatively influence the patient-reported outcomes measures (PROMs) when undergoing total knee arthroplasty (TKA). However, functional outcomes in this select population remains poorly characterized. This study aimed to compare clinical outcomes and rate of achieving Minimal Clinically Important Difference for Improvement (MCID-I) and Minimal Clinically Important Difference for Worsening (MCID-W) between MS and non-MS TKAs.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Orthopaedics, Golden Jubilee University National Hospital, Glasgow G81 4DY, UK.
The optimal procedure for isolated end-stage medial compartment knee osteoarthritis (OA) remains uncertain, with debate persisting between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The aim of this narrative review is to evaluate current outcome measures in knee arthroplasty (KA) and explore how evolving patient populations and technological advancements may necessitate the use of different patient-reported outcome measures (PROMs) for evaluating UKA. While UKA offers potential advantages over TKA in early pain relief and functional outcomes, most randomised control trials using traditional PROMs have failed to show definitive superiority.
View Article and Find Full Text PDFJ Exp Orthop
January 2025
Department of Orthopaedic Surgery and Traumatology Città della Salute e della Scienza Turin Italy.
Purpose: This systematic review and meta-analysis aimed to compare the clinical and radiological outcomes of patients undergoing revision total knee arthroplasty (rTKA) using uncemented press-fit stems (hybrid fixation) versus cemented stems (cemented fixation). It is also examined whether cemented fixation offers any superiority over hybrid fixation regarding implant survival, clinical function, imaging analysis and complication rates.
Methods: Following the PRISMA guidelines, a systematic review and meta-analysis were conducted on five databases (Pubmed, Scopus, Embase, Medline and Cochrane).
Purpose: Double-level osteotomies (DLOs) have shown promising results for knee joint preservation, however, most ultimately progress in terms of degenerative disease resulting in conversion to total knee arthroplasty (TKA). Therefore, the purpose of this study was to examine the time to TKA conversion, long-term clinical outcomes and revision rates of patients who have undergone TKA after prior ipsilateral DLO.
Methods: Patients who underwent simultaneous or staged DLO and subsequently underwent conversion to TKA at a single academic institution from 1997 to 2022 were evaluated.
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