There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis

Abstract

Purpose Chondrocalcinosis is the radiographic appearance of calcium crystals in cartilage and other soft tissue. It is suggested that preoperative chondrocalcinosis predicts a worse outcome after total knee arthroplasty and it is unclear if chondrocalcinosis leads to more postoperative complications. This study aimed to compare function, pain, postoperative complications, postoperative signs of acute arthritis and revision rates between patients with and without chondrocalcinosis undergoing total knee arthroplasty for osteoarthritis. Methods In this retrospective cohort study performed in 2017, 408 knees in 392 patients (16 bilateral total knee arthroplasties) were included. None of the patients received additional synovectomy. PROMs were evaluated after 1 year (n = 294) and 5 years (n = 308). The follow‐up for clinical data was 5 years (n = 408). The range of final follow‐up was 57–84 months. All preoperative radiographs were scored for chondrocalcinosis and Oxford Knee Score, Knee Society Score and Algofunctional Index were used to assess outcome. All clinical records were screened for postoperative complications (excessive wound discharge, infection, loosening, PAO, stiffness), arthritis after surgery and reoperation or revision for any reason. Results Sixty‐three knees (15.4%) showed signs of chondrocalcinosis. Male gender, higher age and lower BMI were risk factors for chondrocalcinosis. No difference was found in Oxford Knee Score, Knee Society Score and Algofunctional Index, nor in postoperative complications, postoperative signs of acute arthritis and revision rate. Conclusion Patients with and without chondrocalcinosis have the same outcome after total knee arthroplasty related to pain, functionality, complications, arthritis and revision after surgery for end‐stage osteoarthritis. Chondrocalcinosis is not a contraindication for total knee arthroplasty and additional synovectomy is unnecessary. Level of evidence III.

Chondrocalcinosis does not affect functional outcome and prosthesis survival in patients after total or unicompartmental knee arthroplasty: a systematic review

“…In one study [ 28 ], the presence of CC was additionally determined on postoperative radiographs. Whereas Lee et al [ 26 ] based their diagnostic criteria on the sole intraoperative, visual presence of CC and Willem et al [ 27 ] on the radiologically visible calcifications.…”

“…After TKA, functional scores and pain improved equally, and no difference in range of motion or KSS between patients with and without CC could be demonstrated (Table 2 ) [ 26 , 27 ]. Furthermore, no significant difference in secondary patellofemoral resurfacing or total revision rates could be observed (Table 3 ).…”

“…Besides one publication, all [21][22][23][25][26][27][28] reported a prevalence of CC at time of surgery between 12.6% and 36%. Lee et al [26] calculated a prevalence of 26.5% based on the intraoperative, visual presence of calcium deposition.…”

“…All included studies analysed the impact or the correlation of CC with the functional outcome, the survivorship and the progression of OA especially in UKA, but also in TKA without patellar resurfacing. There were five (62.5%) prospective cohort studies [21][22][23][24][25] and three retrospective cohort studies Knee Surgery, Sports Traumatology, Arthroscopy [26,27], of which one was with prospective data collection [28]. According to the "MINORS" appraisal tool for nonrandomized control trials, the mean global score was 19.5 for comparative studies.…”

Three-dimensional gait characteristics of patients after unilateral total knee arthroplasty

“…Total knee arthroplasty (TKA) is an effective method for the treatment of advanced knee joint diseases, which can effectively correct knee deformity and improve knee function [1–5] . However, TKA can lead to a partial inability of the knee joint to achieve a healthy knee joint movement.…”