Negative Effects of Knee Replacement

Abstract

Introduction Total knee arthroplasty is the treatment of choice in orthopedic practice for patients with late stage knee osteoarthritis. However, arthroplasty has not only benefit results and the service life of the endoprothesis is limited. The use of modern conservative therapy and joint-preserving surgions allowed to delay or to avoid knee arthroplasty.
 Purpose. The study purpose is the analysis of publications with negative results of knee arthroplasty in patients with knee osteoarthritis.
 Materials and methods. The electronic Pub-Med/MEDLINE and eLibrary databases were searched for reviews published between 2002 and 2022. A keyword search was also done using the terms: knee joint osteoarthritis, total knee replacement/arthroplasty, complications, patient satisfaction, indications/contraindications for surgery; related definitions and descriptions were extracted.
 Results. The negative consequences of total knee arthroplasty are heterogeneous. Complications can be local and systemic such as surgical site infection, periprosthetic fracture, aseptic loosening (asepticinstability) of theendoprosthesis and its wearand the implant failure. The researchers data indicate increasing the number of patients who are not satisfied with the results of arthroplasty both in the short term and in the long-term after the operation, due to the natural wear of the prosthesis. Patients are not satisfied with the results of the operation 8% -30%. In recent years, there have been more publications devoted to the limitation of indication for arthroplasty in pftients with knee osteoarthritis. The replacement of the knee joint with an implant was done unreasonably in great number of cases.A number of patients after total knee arthroplasty require revision surgery within the first 5 years. Currently, the risk of failure of knee arthroplasty with the revision surgery in 10 years after primary arthroplasty is 5-6.8%. The main reasons for revision surgery after primary knee arthroplasty are periprosthetic infection and instability of the implant components, while the results of revision surgery are worse than the primary arthroplasty.