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Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment

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 d...

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Autores principales: Fournier, Gaspard, Gaillard, Romain, Swan, John, Batailler, Cécile, Lustig, Sébastien, Servien, Elvire
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132602/
https://www.ncbi.nlm.nih.gov/pubmed/34009119
http://dx.doi.org/10.1051/sicotj/2021034
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author Fournier, Gaspard
Gaillard, Romain
Swan, John
Batailler, Cécile
Lustig, Sébastien
Servien, Elvire
author_facet Fournier, Gaspard
Gaillard, Romain
Swan, John
Batailler, Cécile
Lustig, Sébastien
Servien, Elvire
author_sort Fournier, Gaspard
collection PubMed
description 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
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spelling pubmed-81326022021-05-24 Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment Fournier, Gaspard Gaillard, Romain Swan, John Batailler, Cécile Lustig, Sébastien Servien, Elvire SICOT J Original Article 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 EDP Sciences 2021-05-19 /pmc/articles/PMC8132602/ /pubmed/34009119 http://dx.doi.org/10.1051/sicotj/2021034 Text en © The Authors, published by EDP Sciences, 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Fournier, Gaspard
Gaillard, Romain
Swan, John
Batailler, Cécile
Lustig, Sébastien
Servien, Elvire
Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title_full Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title_fullStr Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title_full_unstemmed Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title_short Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment
title_sort stiffness after unicompartmental knee arthroplasty: risk factors and arthroscopic treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132602/
https://www.ncbi.nlm.nih.gov/pubmed/34009119
http://dx.doi.org/10.1051/sicotj/2021034
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