Moderate clinical improvement after revision arthroplasty of the severely stiff knee

Heesterbeek, Petra J.C.; Goosen, Jon H. M.; Schimmel, Janneke J. P.; Defoort, Koen C.; Hellemondt, Gijs G. van; Wymenga, A. B.

doi:10.1007/s00167-015-3712-7

Cited by 19 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Particularly arthroscopy represents a significant risk factor for the development of arthrofibrosis [13, 14]. In the investigated patient collective, secondary diseases favouring arthrofibrosis [1, 15] were found in the form of obesity (26.3%), obesity with hyperuricemia (10.5%), hyperuricemia (5.3%) and pre-existing neurological diseases (10.5%). However, no significant accumulation of secondary diseases could be detected.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

et al. 2019

View full text Add to dashboard Cite

PurposeArthrofibrosis after total knee arthroplasty represents a considerable burden for the patient and a therapeutic challenge for the practitioner. One possible cause discussed in the literature is a low-grade infection. This hypothesis should be examined within the scope of this retrospective study.Patients and methodsNineteen patients with clinical symptoms of arthrofibrosis after primary total knee arthroplasty were examined between January, 1999 and January, 2012. Incorrect positioning was radiologically ruled out. All patients were examined clinically (score of Freeman as well as Blauth and Jäger), radiologically (component and leg alignment, patella height according to Insall and Salvati), microbiologically (culture-based procedures), molecular biologically (PCR) and histologically in the course of an open revision of the prosthesis.ResultsAccording to the score of Freeman et al. (1977), a highly significant improvement in pain (p = 0.007) and in the overall score (p = 0.003) was shown. The knee joint mobility did not change significantly (p = 0.795). PCR was negative in 17 patients. One patient showed a PCR-positive result of the synovial membrane for Corynebacterium spp., while Staphylococcus warneri was detected in the culture. Another patient had a positive result of synovia PCR for Enterococcus cecorum as well as Corynebacterium spp. However, this culture was sterile. In 16 patient samples, no bacterial growth was detectable. Two samples were not evaluable. The main histopathological findings were synovialitis and fibrosis.ConclusionThe hypothesis of low-grade-infection-induced arthrofibrosis after total knee arthroplasty could not be confirmed in this study. However, based on this small study population the conclusion needs to be confirmed by new and larger studies, ideally prospectively designed including a control group.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The clinical pathology corresponds to stiff-knee or arthrofibrosis, although a precise definition of the disease is still lacking. Incorrect implant positioning and instabilities can be possible causes [1]. A hypothesis for the development of arthrofibrosis is a low-grade infection [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

et al. 2019

View full text Add to dashboard Cite

show abstract

“…But the improvement was modest (70-72). However, there has been a marked improvement in a 2-year clinical outcome of severe stiffness cases, with the use of Genesis and Legion stemmed condylar prostheses (73). In 2016, Donaldson et al even presented a novel technique for improving stiffness, named by "sloppy" revision (74).…”

Section: Discussionmentioning

confidence: 99%

Hot spots and trends in knee revision research since the 21st century: a bibliometric analysis

2021

View full text Add to dashboard Cite

Background: With the popularization of knee replacement surgery in the treatment of the advanced lesions of knee joint, the amount of knee revision surgery is increasing unceasingly. Meanwhile, the continuous introduction of new clinical concepts and new technology poses a challenge to researchers and surgeons. Our study aims to inform the future scientific research and clinical treatment, by investigating the hot spots and trends of the knee revision research field with the method of bibliometric analysis.Methods: Publications on knee revision included in the database of Web of Science Core Collection (WoSCC) between 2000 and 2018 were reviewed and MeSH terms of them were extracted from PubMed.Online bibliometric analysis website (http://bibliometric.com/), two pieces of software called "CiteSpace" and "Bibliographic Item Co-Occurrence Matrix Builder" (BICOMB) were used to analyze the publications reviewed at quantitative level. Another piece of software called "gCLUTO", was used to investigate the hot spots with visualization techniques at qualitative level.

show abstract

“…It is still important to isolate the cause, otherwise revision may only provide modest improvements. 3,36–38 Keeney et al suggested that revision surgery should be limited to patients with severely restricted motion and extensive flexion contractures. They found that in these cases the postoperative improvements are likely to be limited as a consequence of the severity of stiffness.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Table 5 summarizes the main data from the most important papers reported in recent literature on revision arthroplasty in the stiff TKA. 36–38…”

Section: Treatment Modalitiesmentioning

confidence: 99%

The stiff total knee arthroplasty: causes, treatment modalities and results

Rodríguez-Merchán¹

2019

EFORT Open Reviews

View full text Add to dashboard Cite

It is clear that the stiff total knee arthroplasty (TKA) is a multifactorial entity associated with preoperative, intraoperative and postoperative factors. Management of the stiff TKA is best achieved by preventing its occurrence using strategies to control preoperative factors, avoid intraoperative technical errors and perform aggressive, painless postoperative physical medicine and rehabilitation; adequate pain control is paramount in non-invasive management. Careful attention to surgical exposure, restoring gap balance, minimizing surgical trauma to the patellar ligament/extensor mechanism, appropriate implant selection, pain control and adequate physical medicine and rehabilitation (physiotherapy, Astym therapy) all serve to reduce its incidence. For established stiff TKA, there are multiple treatment options available including mobilization under anaesthesia (MUA), arthroscopic arthrolysis, revision TKA, and combined procedures. Cite this article: EFORT Open Rev 2019;4:602-610. DOI: 10.1302/2058-5241.4.180105

show abstract

Moderate clinical improvement after revision arthroplasty of the severely stiff knee

Abstract: Therapeutic studies-case series with no comparison group, Level IV.

Cited by 19 publications

References 29 publications

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

Hot spots and trends in knee revision research since the 21st century: a bibliometric analysis

The stiff total knee arthroplasty: causes, treatment modalities and results

Contact Info

Product

Resources

About