Background: Arthrofibrosis after TKA is a significant cause of patient dissatisfaction. There is little evidence regarding revision arthroplasty in this patient population. The purpose of this study is to evaluate outcomes after revision TKA for arthrofibrosis.
Methods: We retrospectively reviewed 46 consecutive revision TKAs for arthrofibrosis between 2007 and 2015 with minimum 2-year follow-up. Range of motion (ROM), complication rates, and Knee Society Scores (KSS) were recorded.
Results: Patients were followed for a mean of 59 months. ROM and KSS significantly improved: with flexion improving from 88° to 103° and extension improving from 11° to 3° (P < .001). There was not a relationship between patient or surgical factors and outcomes in this study. The rate of complications was 28.2% with a 17.4% reoperation rate.
Conclusion: While revision for arthrofibrosis after TKA can be associated with significant improvements in ROM and KSS, caution is advised given high rates of revisions, reoperations, and complications. Thirty percent of patients in this series had a decrease in one or more component of the KSS or a net decrease in arc of motion after revision surgery.
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| http://dx.doi.org/10.1016/j.arth.2018.03.037 | DOI Listing |
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Purpose: Despite advances in surgical techniques and rehabilitation protocols, arthrofibrosis following total knee arthroplasty (TKA) still has poor outcomes. In the last decade, attention has been focused on the pathogenesis and cascade of events leading to the development of fibrosis. Currently, one of the most promising approaches consists in the indirect antagonisation of transforming growth factor beta 1 () through the downregulation of the renin-angiotensin-aldosterone system (RAAS).
View Article and Find Full Text PDFFactors associated with arthrofibrosis-related revision following 14,325 total or unicompartmental knee arthro-plasties: an analysis from the Dutch Arthroplasty Registry.
Acta Orthop
October 2024
Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands.
Article Synopsis
- Arthrofibrosis is a condition that affects knee joint movement and can lead to complications following knee replacement surgeries, specifically unicompartmental and total knee arthroplasties.
- A study analyzed data from 14,325 revision surgeries from the Dutch Arthroplasty Registry, examining factors like age, sex, BMI, smoking status, and type of surgery to understand their connection to arthrofibrosis-related revisions.
- Results showed that younger age, male sex, lower BMI, non-smoking status, and total knee arthroplasty were significantly linked to higher rates of revision due to arthrofibrosis.
The Influence of Preimplant Balancing on Manipulation under Anesthesia Rates following Imageless Robotic-Assisted Total Knee Arthroplasty.
J Knee Surg
October 2024
Fulton County Health Center, FCHC Orthopedics, Wauseon, Ohio.
Acquired idiopathic stiffness (AIS) following total knee arthroplasty (TKA) often requires manipulation under anesthesia (MUA). Robotic-assisted TKA (RA-TKA) systems provide gap balance templates for objective correlation with the rate of AIS. The purpose of this study was to assess intraoperative balancing parameters that were associated with MUA utilizing an "anatomical" implant design.
View Article and Find Full Text PDFRotating Hinge Revision Total Knee Arthroplasty Provides Greater Arc of Motion Gains for Patients Who Have Severe Arthrofibrosis.
J Arthroplasty
January 2025
Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York; Hospital for Special Surgery, New York, New York; Weill Cornell Medicine, New York, New York.
Background: Arthrofibrosis is a common postoperative total knee arthroplasty (TKA) complication that results in limited range of motion (ROM). There is limited literature on outcomes after revision TKA (rTKA) for arthrofibrosis based on preoperative ROM restriction. The aims of this study were to: (1) examine ROM trajectory after rTKA for arthrofibrosis patients who have severe versus nonsevere limitations; (2) compare ROM gains and final arc of motion (AOM) between severe and nonsevere cohorts; (2a) compare ROM gain in a severe cohort treated with a rotating hinge (RH) versus a non-RH (NRH) construct; and (3) assess the impact of arthrofibrosis severity on patient-reported outcome measures.
View Article and Find Full Text PDFNeighborhood socioeconomic disadvantage does not predict need for manipulation under anesthesia or range of motion following total knee arthroplasty.
J Orthop
December 2024
Department of Orthopaedics, Tufts Medical Center, Boston, MA, USA.
Background: Studies have linked socioeconomic factors including lower income and minority race with worse functional outcomes following total knee arthroplasty (TKA). Arthrofibrosis is a common complication following TKA, and manipulation under anesthesia (MUA) is an effective treatment option for arthrofibrosis. This study aimed to determine if neighborhood-level socioeconomic disadvantage predicts need for MUA and postoperative range of motion (ROM) among patients undergoing primary elective TKA.
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