Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2016; 7(9): 584-591
Published online Sep 18, 2016. doi: 10.5312/wjo.v7.i9.584
Total knee arthroplasty for treatment of post-traumatic arthritis: Systematic review
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf, Division of Adult Reconstruction, Department of Orthoapedic Surgery, New York University Langone Medical Center, Hospital for Joint Diseases, New York, NY 10003, United States
Author contributions: Saleh H drafted the initial manuscript; Saleh H and Yu S performed the research; Saleh H, Yu S, Vigdorchik J and Schwarzkopf R contributed equally to the work; Vigdorchik J and Schwarzkopf R conceptualized and designed the review; all authors reviewed and approved the final manuscript as submitted.
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.
Data sharing statement: All technical data is available from the corresponding author at schwarzk@gmail.com. Consent was not obtained for data sharing but the presented data is anonymized and the risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ran Schwarzkopf, MD, MSc, Division of Adult Reconstruction, Department of Orthoapedic Surgery, New York University Langone Medical Center, Hospital for Joint Diseases, 301 E 17th Street, New York, NY 10003, United States. ran.schwarzkopf@nyumc.org
Telephone: +1-212-5137711
Received: March 27, 2016
Peer-review started: March 30, 2016
First decision: May 13, 2016
Revised: May 28, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: September 18, 2016
Processing time: 168 Days and 21.9 Hours
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: Total knee arthroplasty; Post-traumatic arthritis; Tibial plateau fracture; Distal femur fracture; Patella fracture

Core tip: There is a paucity in the literature regarding the effectiveness of total knee arthroplasty (TKA) for the treatment of post-traumatic arthritis (PTA). The goal of this systematic review is to summarize the functional outcomes, complications, and survivorship of TKA performed for the treatment of PTA. Majority of studies reported improvements in functional outcomes, increased range of motion, and decreased pain following TKA. There is a significant complication rate, including infection, stiffness, and wound complications. Revisions were performed most commonly for polyethylene wear. Although associated with higher complication rates, TKA is an effective treatment for PTA, as it improves range of motion, pain and functional outcomes.