Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
Autor: | Elvire Servien, Gaspard Fournier, Cécile Batailler, John Swan, Romain Gaillard, Sébastien Lustig |
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Rok vydání: | 2021 |
Předmět: |
musculoskeletal diseases
medicine.medical_specialty animal structures medicine.medical_treatment Total knee arthroplasty Arthroscopic treatment Stiffness 03 medical and health sciences 0302 clinical medicine Arthrolysis medicine Orthopedics and Sports Medicine Revision rate Knee Unicompartmental knee arthroplasty Orthopedic surgery 030222 orthopedics business.industry Unicompartmental Knee Arthroplasty UKA technology industry and agriculture Retrospective cohort study 030229 sport sciences musculoskeletal system Surgery body regions Anticoagulant therapy Original Article medicine.symptom Complication business Range of motion RD701-811 |
Zdroj: | SICOT-J SICOT-J, Vol 7, p 35 (2021) |
ISSN: | 2426-8887 |
Popis: | Introduction: One of the principal complications after total knee arthroplasty (TKA) is stiffness. There are no publications concerning stiffness after unicompartmental knee arthroplasty (UKA). Study objectives were to describe the incidence of stiffness after UKA, to look for risk factors, and to describe safe and effective arthroscopic treatment. Methods: There were 240 UKA performed between March 2016 and January 2019 included. Robotic-assisted surgery was performed in 164 patients and mechanical instrumentation in 76 patients. Stiffness was defined as flexion < 90° or a flexion contracture > 10° during the first 45 post-operative days. Patients with stiffness were treated with arthroscopic arthrolysis. Several factors were studied to look for risk factors of stiffness: body mass index, gender, age, mechanical or robotic instrumentation, preoperative flexion, previous meniscectomy, and anticoagulant treatment. Arthrolysis effectiveness was evaluated by flexion improvement and UKA revision rate. Results: 22 patients (9%) developed stiffness. Mechanical instrumentation significantly increased the risk of stiffness with OR = 0.26 and p = 0.005. Robotic-assisted surgery decreased the risk of stiffness by five-fold. Before arthrolysis, mean knee flexion was 79°, versus 121° (53% improvement) after arthroscopic arthrolysis. Only 2 patients (9%) underwent UKA revision after arthrolysis. Discussion: Stiffness after UKA is an important complication with an incidence of 9% in this study. Arthroscopic arthrolysis is a safe and effective treatment with a range of motion improvement of > 50%. Robotic-assisted surgery significantly decreases the risk of postoperative stiffness. Level of evidence: Level III, therapeutic study, retrospective cohort study |
Databáze: | OpenAIRE |
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