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. 2016 Sep 18;7(9):584-91.
doi: 10.5312/wjo.v7.i9.584.

Total knee arthroplasty for treatment of post-traumatic arthritis: Systematic review

Hesham Saleh  1 , Stephen Yu  1 , Jonathan Vigdorchik  1 , Ran Schwarzkopf  1
Affiliations

Total knee arthroplasty for treatment of post-traumatic arthritis: Systematic review

Hesham Saleh et al. World J Orthop. .

Abstract

Aim: To review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA).

Methods: We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles. We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.

Results: Sixteen studies, four prospective and ten retrospective, examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion (ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.

Conclusion: Although associated with higher complication rates, TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.

Keywords: Distal femur fracture; Patella fracture; Post-traumatic arthritis; Tibial plateau fracture; Total knee arthroplasty.

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Conflict of interest statement

Conflict-of-interest statement: None of the authors have relevant disclosures to make in relation to the submitted study. Schwarzkopf R received research funding, speaker fees, consulting fees, or royalties from Smith and Nephew, Intelijoint. None of the authors own company stock or options. None of the authors own any patents. Schwarzkopf R and Vigdorchik J are on the editorial board Journal of Arthroplasty, Arthroplasty today. None of the authors are a board member of any societies.

Figures

Figure 1
Figure 1
Flowchart summarizing the results of the literature search. TKA: Total knee arthroplasty.
Figure 2
Figure 2
Comparison of pre- and post-operative Knee Society Scores function scores for patients who underwent total knee arthroplasty for treatment of post-traumatic arthritis. KSS: Knee Society Scores; Op: Operative.
Figure 3
Figure 3
Comparison of pre- and post-operative Knee Society Scores knee scores for patients who underwent total knee arthroplasty for treatment of post-traumatic arthritis. KSS: Knee Society Scores; Op: Operative.
Figure 4
Figure 4
Comparison of average pre- and post-operative range of motions of the knee for patients who underwent total knee arthroplasty for treatment of post-traumatic arthritis. Op: Operative.
Figure 5
Figure 5
Comparison of survivorship at the longest time of follow-up of total knee arthroplasty performed for post-traumatic arthritis vs primary osteoarthritis. OA: Osteoarthritis; PTA: Post-traumatic arthritis.
See this image and copyright information in PMC

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