Total Knee Arthroplasty Complications
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https://doi.org/10.5281/zenodo.10722045Keywords:
Knee Prosthesis, Total Knee Replacement, ComplicationsAbstract
(TKA) and to evaluate the clinical and radiological outcomes of TKA patients.
Methods: A total of 376 knees from 319 patients who underwent Total Knee Arthroplasty (TKA) at our hospital were included in the study. The patients' medical histories, preoperative examination findings, X-rays, laboratory data, surgical informations, postoperative follow-up period, complications, and postoperative antero-posterior and lateral radiographs were evaluated. Preoperative and postoperative varus-valgus alignment angles, postoperative alpha, beta, gamma, sigma and omega angles were measured on the radiographs. The patients were evaluated using the Knee Society Score (KSS) for the clinical and radiological evaluation of knee arthroplasty.
Results: The mean age of the patients was 67.7 (35-87) and 252 (79%) were women. Mean follow-up duration was 32.6 months (4-92). Both the KSS knee score and the function score significantly improved after surgery (p < 0.0001). The mean preoperative range of motion was 108.3° (70-135°), and the mean postoperative range of motion was 113.2° (70-140°) (p=0.014). Early infection was the most common complication (3.4%). Other complications included chronic infection (1.2%), wound complications (1.5%), peroneal nerve injury (0.6%), infrapatellar branch of the saphenous nerve neuroma (0.3%), deep vein thrombosis (1.5%), extensor mechanism complications (0.6%), limited range of motion (0.6%), aseptic loosening (0.6%), and supracondylar femoral fracture (0.3%). Radiographic measurements showed that most patients achieved proper alignment.
Conclusion: Total knee arthroplasty (TKA) is an effective treatment method for pain and functional impairment. The most common complication of TKA is early infection. In most cases of early infection, there was no evidence of bacterial growth. We found that the second most common complication was deep vein thrombosis (DVT). In order to reduce these complications, further research is needed to improve infection prevention strategies and perioperative care.
References
Abdel, M. P., Ollivier, M., Parratte, S., Trousdale, R. T., Berry, D. J. ve Pagnano, M. W. (2018). Effect of postoperativemechanical axis alignment on survival and functional outcomes of modern total knee arthroplasties with cement: A concise follow-up at 20 years. Journal of Bone and Joint Surgery - American Volume, 100(6), 472-478. doi:10.2106/JBJS.16.01587
Adams, A. L., Paxton, E. W., Wang, J. Q., Johnson, E. S., Bayliss, E. A., Ferrara, A., … Namba, R. S. (2013). Surgical outcomes of total knee replacement according to diabetes status and glycemic control, 2001 to 2009. Journal of Bone and Joint Surgery, 95(6), 481-487. doi:10.2106/JBJS.L.00109
Arduino, J. M., Kaye, K. S., Reed, S. D., Peter, S. A., Sexton, D. J., Chen, L. F., … Anderson, D. J. (2015). Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. Antimicrobial resistance and infection control, 4(13), 13. doi:10.1186/s13756-015-0057-4
Block, J. E. ve Stubbs, H. a. (2005). Reducing the risk of deep wound infection in primary joint arthroplasty with antibiotic bone cement. Orthopedics, 28(11), 1334-45.
Carender, C. N., Bedard, N. A., An, Q. ve Brown, T. S. (2020). Common Peroneal Nerve Injury and Recovery after Total Knee Arthroplasty: A Systematic Review. Arthroplasty Today, 6(4), 662-667. doi:10.1016/j.artd.2020.07.017
Cherian, J. J., Jauregui, J. J., Banerjee, S., Pierce, T. ve Mont, M. A. (2015, 3 Ağustos). What Host Factors Affect Aseptic Loosening After THA and TKA? Clinical Orthopaedics and Related Research. Springer New York LLC. doi:10.1007/s11999-015-4220-2
Daines, B. K., Dennis, D. A. ve Amann, S. (2015, 25 Haziran). Infection prevention in total knee arthroplasty. Journal of the American Academy of Orthopaedic Surgeons. Lippincott Williams and Wilkins. doi:10.5435/JAAOS-D-12-00170
Darouiche, R. O. (2003). Antimicrobial approaches for preventing infections associated with surgical implants. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 36(10), 1284-9. doi:10.1086/374842
Gandhi, R., Razak, F., Pathy, R., Davey, J. R., Syed, K. ve Mahomed, N. N. (2009). Antibiotic bone cement and the incidence of deep infection after total knee arthroplasty. The Journal of arthroplasty, 24(7), 1015-8. doi:10.1016/j.arth.2008.08.004
Gehrke, T., Zahar, A., Kendoff, D., Gehrke, T, Zahar, A ve Kendoff, A. D. (2013). One-stage exchange IT ALL BEGAN HERE. Bone Joint J, 95(11), 77-83. doi:10.1302/0301-620X.95B11
Gkiatas, I., Karasavvidis, T., Sharma, A. K., Xiang, W., Malahias, M. A., Chalmers, B. P. ve Sculco, P. K. (2022, 1 Haziran). Highly cross-linked polyethylene in primary total knee arthroplasty is associated with a lower rate of revision for aseptic loosening: a meta-analysis of 962,467 cases. Archives of Orthopaedic and Trauma Surgery. Springer Science and Business Media Deutschland GmbH. doi:10.1007/s00402-021-03887-z
Jämsen, E., Huhtala, H., Puolakka, T. ve Moilanen, T. (2009). Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. The Journal of bone and joint surgery. American volume, 91(1), 38-47. doi:10.2106/JBJS.G.01686
Jiranek, W. A., Hanssen, A. D. ve Greenwald, A. S. (2006). Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement. The Journal of bone and joint surgery. American volume, 88(11), 2487-2500. doi:10.2106/JBJS.E.01126
Josefsson, G. ve Kolmert, L. (1993). Prophylaxis with systematic antibiotics versus gentamicin bone cement in total hip arthroplasty. A ten-year survey of 1,688 hips. Clinical orthopaedics and related research, (292), 210-4.
Konan, S., Sandiford, N., Unno, F., Masri, B. S., Garbuz, D. S. ve Duncan, C. P. (2016). Periprosthetic fractures associated with total knee arthroplasty. The Bone & Joint Journal, 98-B(11), 1489-1496. doi:10.1302/0301-620X.98B11.BJJ-2016-0029.R1
Laskin, R. S. ve Beksac, B. (2004). Stiffness after total knee arthroplasty. The Journal of Arthroplasty, 19(4), 41-46. doi:10.1016/j.arth.2004.02.008
Lewis, C. G., Inneh, I. A., Schutzer, S. F. ve Grady-Benson, J. (2014). Evaluation of the first-generation AAOS clinical guidelines on the prophylaxis of venous thromboembolic events in patients undergoing total joint arthroplasty experience with 3289 patients from a single institution. Journal of Bone and Joint Surgery - American Volume, 96(16), 1327-1332. doi:10.2106/JBJS.M.00503
Lieberman, J. R. ve Heckmann, N. (2017). Venous thromboembolism prophylaxis in total hip arthroplasty and total knee arthroplasty patients: From guidelines to practice. Journal of the American Academy of Orthopaedic Surgeons. Lippincott Williams and Wilkins. doi:10.5435/JAAOS-D-15-00760
Lindberg-Larsen, M., Odgaard, A., Fredborg, C. ve Schrøder, H. M. (2021). One-stage versus two-stage revision of the infected knee arthroplasty - a randomized multicenter clinical trial study protocol. BMC Musculoskeletal Disorders, 22(1), 175. doi:10.1186/s12891-021-04044-8
Maempel, J. F., Riddoch, F., Calleja, N. ve Brenkel, I. J. (2015). Longer hospital stay, more complications, and increased mortality but substantially improved function after knee replacement in older patients. Acta Orthopaedica, 86(5), 1-6. doi:10.3109/17453674.2015.1040304
Mandalia, V., Eyres, K., Schranz, P. ve Toms, A. D. (2008). Evaluation of patients with a painful total knee replacement. The Journal of bone and joint surgery. British volume, 90(3), 265-271. doi:10.1302/0301-620X.90B3.20140
Marchant, M. H., Viens, N. A., Cook, C., Vail, T. P. ve Bolognesi, M. P. (2009). The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. The Journal of bone and joint surgery. American volume, 91(7), 1621-1629. doi:10.2106/JBJS.H.00116
Meehan, J., Jamali, A. a, Nguyen, H., Meehan, B. J., Jamali, A. a ve Nguyen, H. (2009). Prophylactic antibiotics in hip and knee arthroplasty. The Journal of bone and joint surgery. American volume, 91(10), 2480-90. doi:10.2106/JBJS.H.01219
Nam, D., Abdel, M. P., Cross, M. B., LaMont, L. E., Reinhardt, K. R., McArthur, B. A., … Sculco, T. P. (2014, 19 Mart). The management of extensor mechanism complications in total knee arthroplasty: AAOS exhibit selection. Journal of Bone and Joint Surgery. Journal of Bone and Joint Surgery Inc. doi:10.2106/JBJS.M.00949
Pangaud, C., Ollivier, M. ve Argenson, J. N. (2019). Outcome of single-stage versus two-stage exchange for revision knee arthroplasty for chronic periprosthetic infection. EFORT Open Reviews, 4(8), 495-502. doi:10.1302/2058-5241.4.190003
Pozo, J. L. Del ve Patel, R. (2009). Infection Associated with Prosthetic Joints. The New England journal of medicine, 361(8), 787. doi:10.1056/NEJMCP0905029
Price, A. J., Alvand, A., Troelsen, A., Katz, J. N., Hooper, G., Gray, A., … Beard, D. (2018, 3 Kasım). Knee replacement. The Lancet. Lancet Publishing Group. doi:10.1016/S0140-6736(18)32344-4
Puijk, R., Rassir, R., Kok, L. M., Sierevelt, I. N. ve Nolte, P. A. (2022). Common peroneal nerve palsy after TKA in valgus deformities; a systematic review. Journal of Experimental Orthopaedics, 9(1), 12. doi:10.1186/s40634-021-00443-x
Pulido, L., Ghanem, E., Joshi, A., Purtill, J. J. ve Parvizi, J. (2008). Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clinical orthopaedics and related research, 466(7), 1710-5. doi:10.1007/s11999-008-0209-4
RITTER, M. A., HARTY, L. D., DAVIS, K. E., MEDING, J. B. ve BEREND, M. E. (2003). PREDICTING RANGE OF MOTION AFTER TOTAL KNEE ARTHROPLASTY. The Journal of Bone and Joint Surgery-American Volume, 85(7), 1278-1285. doi:10.2106/00004623-200307000-00014
Ritter, M. A., Davis, K. E., Meding, J. B., Pierson, J. L., Berend, M. E. ve Malinzak, R. A. (2011). The effect of alignment and BMI on failure of total knee replacement. Journal of Bone and Joint Surgery, 93(17), 1588-1596. doi:10.2106/JBJS.J.00772
Salar, O., Phillips, J. ve Porter, R. (2021). Diagnosis of knee prosthetic joint infection; aspiration and biopsy. The Knee, 30, 249-253. doi:10.1016/J.KNEE.2020.12.023
Segawa, H., Tsukayama, D. T., Kyle, R. F., Becker, D. A. ve Gustilo, R. B. (1999). Infection after total knee arthroplasty. A retrospective study of the treatment of eighty-one infections. The Journal of bone and joint surgery. American volume, 81(10), 1434-1445. doi:10.2106/00004623-199910000-00008
Sundfeldt, M., Carlsson, L. V., Johansson, C. B., Thomsen, P. ve Gretzer, C. (2006, 1 Nisan). Aseptic loosening, not only a question of wear: A review of different theories. Acta Orthopaedica. doi:10.1080/17453670610045902
Szymski, D., Walter, N., Alt, V. ve Rupp, M. (2022). Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany. Journal of Clinical Medicine, 11(17), 5042. doi:10.3390/jcm11175042
Tunney, M. M., Patrick, S., Gorman, S. P., Nixon, J. R., Anderson, N., Davis, R. I., … Ramage, G. (1998). Improved detection of infection in hip replacements. A currently underestimated problem. The Journal of bone and joint surgery. British volume, 80(4), 568-572. doi:10.1302/0301-620X.80B4.8473
Walter, N., Rupp, M., Hierl, K., Koch, M., Kerschbaum, M., Worlicek, M. ve Alt, V. (2021). Long-Term Patient-Related Quality of Life after Knee Periprosthetic Joint Infection. Journal of Clinical Medicine, 10(5), 1-9. doi:10.3390/JCM10050907
Wang, J., Zhu, C., Cheng, T., Peng, X., Zhang, W., Qin, H. ve Zhang, X. (2013). A systematic review and meta-analysis of antibiotic-impregnated bone cement use in primary total hip or knee arthroplasty. PLoS ONE, 8(12), 4-11. doi:10.1371/journal.pone.0082745
Wininger, D. A. ve Fass, R. J. (1996). Antibiotic-impregnated cement and beads for orthopedic infections. Antimicrobial agents and chemotherapy, 40(12), 2675-2679. doi:10.1128/AAC.40.12.2675
Wong, S. Y. W., Ler, F. L. S., Sultana, R. ve Bin Abd Razak, H. R. (2022). What is the best prophylaxis against venous thromboembolism in Asians following total knee arthroplasty? A systematic review and network meta-analysis. Knee Surgery & Related Research, 34(1), 37. doi:10.1186/s43019-022-00166-y
Wooley, P. H. ve Schwarz, E. M. (2004, Şubat). Aseptic loosening. Gene Therapy. doi:10.1038/sj.gt.3302202
Yercan, H. S., Selmi, T. A. S., Sugun, T. S. ve Neyret, P. (2005). Tibiofemoral instability in primary total knee replacement: A review: Part 2: Diagnosis, patient evaluation, and treatment. Knee. Elsevier. doi:10.1016/j.knee.2005.01.005
Yoo, J. D. ve Kim, N. K. (2015, 1 Mart). Periprosthetic fractures following total knee arthroplasty. Knee Surgery and Related Research. BioMed Central Ltd. doi:10.5792/ksrr.2015.27.1.1
Zimmerli, W. ve Ochsner, P. E. (2003). Management of infection associated with prosthetic joints. Infection, 31(2), 99-108. doi:10.1007/S15010-002-3079-9
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