Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec;40(12):3308-3314.
doi: 10.1016/j.arth.2025.05.085. Epub 2025 May 28.

Acute Arthrotomy Dehiscence After Primary Total Knee Arthroplasty: Depth of Injury Impacts Outcome

Colin C Neitzke  1 , Isaiah K Selkridge  1 , Allina A Nocon  1 , Andrew J Hughes  2 , Elizabeth B Gausden  1 , Brian P Chalmers  1 , Peter K Sculco  1
Affiliations

Acute Arthrotomy Dehiscence After Primary Total Knee Arthroplasty: Depth of Injury Impacts Outcome

Colin C Neitzke et al. J Arthroplasty. 2025 Dec.

Abstract

Background: Arthrotomy dehiscence is a challenging complication following total knee arthroplasty (TKA). As early mobilization and fast-track rehabilitation protocols become increasingly popular, arthrotomy dehiscence incidence will likely increase. This study aimed to evaluate the clinical outcomes of acute, traumatic arthrotomy dehiscence, with and without superficial skin involvement, following primary TKA.

Methods: A retrospective review identified 39 acute (< 90 days), surgically managed arthrotomy dehiscences following primary TKA. The arthrotomy + skin dehisced in 25 (64%) cases, while the other 14 (36%) involved the arthrotomy only. The mean time from TKA to dehiscence was longer in the arthrotomy-only cohort (31 versus 17 days, P = 0.005), as was the time from dehiscence to repair (13.1 versus 1.9 days, P < 0.0001). Failure was defined as all-cause reoperation or reoperation for periprosthetic joint infection (PJI).

Results: The 1-year survivorship free from all-cause reoperation was 75%. When stratified by arthrotomy type, 1-year survivorship free from all-cause reoperation was 73% for the arthrotomy-only cohort versus 76% for the arthrotomy + skin cohort (P = 0.94). At 6 months, survivorship free from reoperation for PJI was 100% in the arthrotomy-only cohort versus 83% in the arthrotomy and skin cohort (P = 0.13). There were eight (21%) total failures, including four PJIs, all occurring in the arthrotomy and skin cohort, and four extensor mechanism complications, three of which occurred in the arthrotomy-only cohort and one in the arthrotomy + skin cohort (P = 0.28).

Conclusions: Overall, arthrotomy dehiscence, regardless of superficial skin involvement, shows concerningly low 1-year all-cause reoperation survivorship. Arthrotomy dehiscence with early, aggressive treatment had poor early survivorship free from reoperation for PJI. Our results suggest that surgeons should take all possible precautions to prevent infection and counsel patients regarding the risk of infection and potential extensor mechanism complications following traumatic arthrotomy dehiscence events.

Keywords: arthrotomy dehiscence; extensor mechanism complications; perioperative outcomes; periprosthetic joint infection; total knee arthroplasty.

PubMed Disclaimer

LinkOut - more resources