Primary total knee arthroplasty in patients with post- polio syndrome ARTHROFIBROSIS RATES DOUBLE IN THE AFFECTED LIMB

被引:1
作者
Karczewski, D. [1 ]
Siljander, M. P. [1 ]
Larson, D. R. [2 ]
Taunton, M. J. [1 ]
Lewallen, D. G. [1 ]
Abdel, M. P. [1 ]
机构
[1] Mayo Clin, Dept Orthoped Surg, Rochester, MN 55905 USA
[2] Mayo Clin, Hlth Sci Res, Rochester, MN USA
关键词
POSTPOLIO SYNDROME; POLIOMYELITIS; SURVIVORSHIP; OUTCOMES;
D O I
10.1302/0301-620X.105B6.BJJ-2022-0988.R2
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Aims Knowledge on total knee arthroplasties (TKAs) in patients with a history of poliomyelitis is limited. This study compared implant survivorship and clinical outcomes among affected and unaffected limbs in patients with sequelae of poliomyelitis undergoing TKAs. Methods A retrospective review of our total joint registry identified 94 patients with post-polio syndrome undergoing 116 primary TKAs between January 2000 and December 2019. The mean age was 70 years (33 to 86) with 56% males (n = 65) and a mean BMI of 31 kg/m(2) (18 to 49). Rotating hinge TKAs were used in 14 of 63 affected limbs (22%), but not in any of the 53 unaffected limbs. Kaplan-Meier survivorship analyses were completed. The mean follow-up was eight years (2 to 19). Results The ten-year survivorship free from revision was 91% (95% confidence interval (CI) 81 to 100) in affected and 84% (95% CI 68 to 100) in unaffected limbs. There were six revisions in affected limbs: three for periprosthetic femoral fractures and one each for periprosthetic joint infection (PJI), patellar clunk syndrome, and instability. Unaffected limbs were revised in four cases: two for instability and one each for PJI and tibial component loosening. The ten-year survivorship free from any reoperation was 86% (95% CI 75 to 97) and 80% (95% CI 64 to 99) in affected and unaffected limbs, respectively. There were three additional reoperations among affected and two in unaffected limbs. There were 12 nonoperative complications, including four periprosthetic fractures. Arthrofibrosis occurred in five affected (8%) and two unaffected limbs (4%). Postoperative range of motion decreased with 31% achieving less than 90 & DEG; knee flexion by five years. Conclusion TKAs in post -polio patients are complex cases associated with instability, and one in four require constraint on the affected side. Periprosthetic fracture was the main mode of failure. Arthrofibrosis rates were high and twice as frequent in affected limbs.
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页码:635 / 640
页数:6
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