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Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review

BACKGROUND: Stiffness and pain from arthrofibrosis following total knee arthroplasty (TKA) is a challenging problem, and investigating methods to prevent or reduce the incidence of postoperative arthrofibrosis is critical. Studies have shown that angiotensin-converting enzyme inhibitors (ACEIs) and...

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Autores principales: Langston, Joseph R., Ramsey, Duncan C., Skoglund, Kathryn, Schabel, Kathryn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017493/
https://www.ncbi.nlm.nih.gov/pubmed/32050991
http://dx.doi.org/10.1186/s13018-020-1555-5
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author Langston, Joseph R.
Ramsey, Duncan C.
Skoglund, Kathryn
Schabel, Kathryn
author_facet Langston, Joseph R.
Ramsey, Duncan C.
Skoglund, Kathryn
Schabel, Kathryn
author_sort Langston, Joseph R.
collection PubMed
description BACKGROUND: Stiffness and pain from arthrofibrosis following total knee arthroplasty (TKA) is a challenging problem, and investigating methods to prevent or reduce the incidence of postoperative arthrofibrosis is critical. Studies have shown that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are efficacious at preventing fibrotic disorders in the lungs, liver, kidneys, and eyes. Our aim was to determine if ACEI or ARB use postoperatively reduces the incidence of arthrofibrosis in TKA patients. METHODS: In a retrospective review, we analyzed 141 consecutive TKAs performed at a single institution by a single surgeon from December 2010 to December 2014. Range of motion (ROM) in patients already taking ACEI, ARB, or neither medication was compared. Independent variables recorded were gender, age, BMI, presence of diabetes or preoperative opioid or statin use, preoperative ROM, and use of ACEIs or ARBs. Dependent variables recorded were postoperative knee flexion, extension, and total arc of motion. The primary outcome variable was success or failure of achieving 118(o) total arc of motion postoperatively, based on a study that found significant compromise of function in TKA patients who failed to obtain this goal. Secondary endpoints were postoperative knee flexion, extension, and total arc of motion. RESULTS: The use of neither ACEIs nor ARBs showed a significant difference in attaining greater than 118° of motion postoperatively compared to controls at 6 months. Significant predictors of obtaining > 118° motion were BMI (p < 0.05), preoperative flexion (p < 0.001), and preoperative total arc of motion (p < 0.002). Significant predictors of secondary ROM outcomes were preoperative ROM and BMI. CONCLUSIONS: Our study demonstrated that the principle predictor of postoperative ROM is BMI and preoperative ROM. The use of ACEIs or ARBs did not result in a greater likelihood of obtaining satisfactory ROM postoperatively.
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spelling pubmed-70174932020-02-20 Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review Langston, Joseph R. Ramsey, Duncan C. Skoglund, Kathryn Schabel, Kathryn J Orthop Surg Res Research Article BACKGROUND: Stiffness and pain from arthrofibrosis following total knee arthroplasty (TKA) is a challenging problem, and investigating methods to prevent or reduce the incidence of postoperative arthrofibrosis is critical. Studies have shown that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are efficacious at preventing fibrotic disorders in the lungs, liver, kidneys, and eyes. Our aim was to determine if ACEI or ARB use postoperatively reduces the incidence of arthrofibrosis in TKA patients. METHODS: In a retrospective review, we analyzed 141 consecutive TKAs performed at a single institution by a single surgeon from December 2010 to December 2014. Range of motion (ROM) in patients already taking ACEI, ARB, or neither medication was compared. Independent variables recorded were gender, age, BMI, presence of diabetes or preoperative opioid or statin use, preoperative ROM, and use of ACEIs or ARBs. Dependent variables recorded were postoperative knee flexion, extension, and total arc of motion. The primary outcome variable was success or failure of achieving 118(o) total arc of motion postoperatively, based on a study that found significant compromise of function in TKA patients who failed to obtain this goal. Secondary endpoints were postoperative knee flexion, extension, and total arc of motion. RESULTS: The use of neither ACEIs nor ARBs showed a significant difference in attaining greater than 118° of motion postoperatively compared to controls at 6 months. Significant predictors of obtaining > 118° motion were BMI (p < 0.05), preoperative flexion (p < 0.001), and preoperative total arc of motion (p < 0.002). Significant predictors of secondary ROM outcomes were preoperative ROM and BMI. CONCLUSIONS: Our study demonstrated that the principle predictor of postoperative ROM is BMI and preoperative ROM. The use of ACEIs or ARBs did not result in a greater likelihood of obtaining satisfactory ROM postoperatively. BioMed Central 2020-02-12 /pmc/articles/PMC7017493/ /pubmed/32050991 http://dx.doi.org/10.1186/s13018-020-1555-5 Text en © The Author(s). 2020 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
Langston, Joseph R.
Ramsey, Duncan C.
Skoglund, Kathryn
Schabel, Kathryn
Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title_full Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title_fullStr Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title_full_unstemmed Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title_short Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
title_sort angiotensin ii blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017493/
https://www.ncbi.nlm.nih.gov/pubmed/32050991
http://dx.doi.org/10.1186/s13018-020-1555-5
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