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What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?

BACKGROUND: Wound condition after primary total knee arthroplasty (TKA) is an important issue to avoid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. METHODS: A total of 139 knees in 128 patients (mean 7...

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Autores principales: Harato, Kengo, Tanikawa, Hidenori, Morishige, Yutaro, Kaneda, Kazuya, Niki, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712504/
https://www.ncbi.nlm.nih.gov/pubmed/26762213
http://dx.doi.org/10.1186/s13018-016-0340-y
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author Harato, Kengo
Tanikawa, Hidenori
Morishige, Yutaro
Kaneda, Kazuya
Niki, Yasuo
author_facet Harato, Kengo
Tanikawa, Hidenori
Morishige, Yutaro
Kaneda, Kazuya
Niki, Yasuo
author_sort Harato, Kengo
collection PubMed
description BACKGROUND: Wound condition after primary total knee arthroplasty (TKA) is an important issue to avoid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. METHODS: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m(2)), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. RESULTS: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. CONCLUSIONS: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.
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spelling pubmed-47125042016-01-15 What are the important surgical factors affecting the wound healing after primary total knee arthroplasty? Harato, Kengo Tanikawa, Hidenori Morishige, Yutaro Kaneda, Kazuya Niki, Yasuo J Orthop Surg Res Research Article BACKGROUND: Wound condition after primary total knee arthroplasty (TKA) is an important issue to avoid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. METHODS: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m(2)), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. RESULTS: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. CONCLUSIONS: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA. BioMed Central 2016-01-13 /pmc/articles/PMC4712504/ /pubmed/26762213 http://dx.doi.org/10.1186/s13018-016-0340-y Text en © Harato et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Harato, Kengo
Tanikawa, Hidenori
Morishige, Yutaro
Kaneda, Kazuya
Niki, Yasuo
What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title_full What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title_fullStr What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title_full_unstemmed What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title_short What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
title_sort what are the important surgical factors affecting the wound healing after primary total knee arthroplasty?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712504/
https://www.ncbi.nlm.nih.gov/pubmed/26762213
http://dx.doi.org/10.1186/s13018-016-0340-y
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