Total Knee Arthroplasty in a Previously Ankylosed or Arthrodesed Knee

Naranja, R. John; Lotke, Paul A.; Pagnano, Mark W.; Hanssen, Arlen D.

doi:10.1097/00003086-199610000-00033

Cited by 65 publications

(44 citation statements)

References 7 publications

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“…The tibiofemoral fusion site was osteotomised at the estimated junction with care taken to preserve bone stock [3,5]. In order to overcome the quadriceps contraction, some authors performed a VY quadricepsplasty to enhance postoperative knee flexion [3,12]. Soft tissue releases were performed as needed to correct angular and flexion deformity [3][4][5]12].…”

Section: Surgical Techniquementioning

confidence: 99%

“…In order to overcome the quadriceps contraction, some authors performed a VY quadricepsplasty to enhance postoperative knee flexion [3,12]. Soft tissue releases were performed as needed to correct angular and flexion deformity [3][4][5]12]. Henkel et al [7] resurfaced the patella in two cases.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Some authors advocate the procedure [5,6,[9][10][11], while others have expressed concern over its efficacy in the presence of the high complication rate [1,2,7,12]. Thus, a systematic review and meta-analyses of the current literature was done, to examine the role of TKA after AD of the knee and assess the clinical outcome, complications, surgical technique, patientrelated outcome measures and methodological quality.…”

Section: Introductionmentioning

confidence: 99%

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Conversion from knee arthrodesis to arthroplasty: systematic review

Kernkamp

Verra

Pijls

et al. 2016

International Orthopaedics (SICOT)

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Purpose Arthrodesis (AD) of the knee reduces pain and provides stability, but has severe functional and social limitations. There has been ample discussion on the value of a conversion of an AD to a total knee arthroplasty (TKA). The aim of this study was to perform a review and meta-analysis of the current literature on conversion of an AD to TKA and assess clinical outcome, complication rate, surgical technique and overall patient-related outcome measures. Methods PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, Academic Search Premier, ScienceDirect and searching by hand for papers on conversion of AD of the knee to TKA. Two reviewers independently reviewed all titles and abstracts, and extracted the available data. Study eligibility criteria were: conversion of knee AD to TKA, five cases or more and non-oncology patients. Data consisted of study characteristics, patient demographics, clinical outcome and complications. Additionally, details on surgical technique were reviewed. Results Of the 866 unique references identified, six papers were included for further analyses, comprising a total of 123 knees with conversion of AD of the knee to TKA. Mean gain of knee flexion was 80 degrees and the mean HSS score improved with 20 points. A complicated postoperative course was found in 65 % of all cases. The most frequent complication was skin necrosis (25 %), followed by arthrofibrosis (13 %), infection (11 %) and revision (11 %). Major complications such as refusion, amputation and death occurred in less than 5 % of all cases. Discussion The majority of the papers consisted of small case series of moderate methodological quality, resulting in 123 included knees. Further series are necessary to draw definitive conclusions. Conclusions This is the first systematic review and metaanalysis on conversion of a knee arthrodesis to TKA. Good clinical results can be expected after conversion, albeit at a high risk of postoperative complications.

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Section: Surgical Techniquementioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Conversion from knee arthrodesis to arthroplasty: systematic review

Kernkamp

Verra

Pijls

et al. 2016

International Orthopaedics (SICOT)

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“…Therefore, preoperative ROM of 50°o r less is a challenging dilemma for surgeons. Some investigators have described inconsistent ROM, high risk of complications, and high revision rates, especially in patients with ankylosed knees [18,22]. However, others have reported that postoperative ROM in patients with stiff and ankylosed knees can be the same as ROM in patients with flexible knees, and low complication rates in these TKAs [20,21].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous studies had small patients cohorts [1, 3, 4, 10-13, 15, 16, 19, 21, 26], and although higher complication rates and suboptimal outcomes after TKA were reported, there may be a tendency to underestimate complications [22]. Two studies had large patient cohorts [3,24].…”

Section: Introductionmentioning

confidence: 99%

Does TKA Improve Functional Outcome and Range of Motion in Patients with Stiff Knees?

Kim

2009

Clinical Orthopaedics &Amp; Related Research

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The main goals of TKA are pain relief and improvement of function and range of motion (ROM). To ascertain whether TKA in patients with stiff knees would relieve pain and improve functional outcome and ROM, we asked four questions: whether (1) Knee Society and WO-MAC scores would improve after TKA; (2) poor preoperative ROM would improve after TKA; (3) the revision rate of TKA in stiff knees would be high; and (4) complication rates would be high in these patients after TKA. We retrospectively reviewed 74 patients (86 knees) with stiff knees (mean age, 56.8 years) who underwent TKAs with a condylar constrained or a posterior stabilized prosthesis. The minimum followup was 5 years (mean, 9.1 years; range, 5-12 years). The mean preoperative Hospital for Special Surgery knee score and Knee Society knee and functional scores were 42, 11, and 42 points, respectively, and postoperatively they were 84, 90, and 84 points, respectively. Preoperative and postoperative total WOMAC scores were 73 and 34 points, respectively. One knee (1.2%) had aseptic loosening of the tibial component and 12 knees (14%) had complications. Despite a relatively high rate of complications, most patients had substantial improvement in function.

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