Factors associated with arthrofibrosis-related revision following 14,325 total or unicompartmental knee arthro-plasties: an analysis from the Dutch Arthroplasty Registry

Authors

  • Myrthe P F van de Ven Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands https://orcid.org/0009-0006-8288-4103
  • Joris Bongers Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen; Department of Orthopaedic Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
  • Anneke Spekenbrink-Spooren Dutch Arthroplasty Registry (Landelijke Registratie Orthopedische Interventies), ‘s-Hertogenbosch, The Netherlands
  • Sander Koëter Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands https://orcid.org/0000-0002-3987-734X

DOI:

https://doi.org/10.2340/17453674.2024.41988

Keywords:

Arthrofibrosis, Arthroplasty, Implants, Knee, Revision

Abstract

Background and purpose: Arthrofibrosis is a fibrotic joint disorder that can impair the results of knee arthroplasty surgery by limiting the range of motion, functionality, and quality of life. We aimed to investigate whether patient and procedural characteristics are associated with arthrofibrosis-related revision following unicompartmental and total knee arthroplasty (UKA and TKA).
Methods: A prospective observational study was conducted using data from the Dutch Arthroplasty Registry. We included 14,325 revisions performed in 2014–2022 following primary knee arthroplasty. Demographic and surgical characteristics including age, sex, BMI, smoking status, and prosthesis type (TKA versus UKA) were analyzed. Multiple logistic regression was performed to investigate associations between these factors and arthrofibrosis-related revisions, compared with other reasons.
Results: Revisions were due to arthrofibrosis in 711 (5%) patients. There were significantly higher associations for younger age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96–0.97)), male sex (OR 1.2, CI 1.0–1.4), lower BMI (OR 0.97, CI 0.95–0.98), non-smoking status (OR 1.7, CI 1.2–2.3), and TKA (OR 7.7, CI 5.2–12), for arthrofibrosis-related revision compared with any other reason for revision.
Conclusion: Younger patients, men, non-smokers, patients with a lower BMI, and those who had primary TKA were more often associated with revision due to arthrofibrosis than other reasons for revision.

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References

Usher K M, Zhu S, Mavropalias G, Carrino J A, Zhao J, Xu J. Pathological mechanisms and therapeutic outlooks for arthrofibrosis. Bone Res 2019; 7(1): 9. doi: 10.1038/s41413-019-0047-x

Vun S H, Shields D W, Sen A, Shareef S, Sinha S, Campbell A C. A national questionnaire survey on knee manipulation following total knee arthroplasty. J Orthop 2015; 12(4): 193-6. doi: 10.1016/j.jor.2015.05.016

Yercan H S, Sugun T S, Bussiere C, Selmi T A S, Davies A, Neyret P. Stiffness after total knee arthroplasty: prevalence, management and outcomes. Knee 2006; 13(2): 111-17. doi: 10.1016/j.knee.2005.10.001.

Kim J, Nelson C L, Lotke P A. Stiffness after total knee arthroplasty: prevalence of the complication and outcomes of revision. J Bone Joint Surg Am 2004; 86(7): 1479-84.

Schairer W W, Vail T P, Bozic K J. What are the rates and causes of hospital readmission after total knee arthroplasty? Clin Orthop Relat Res 2014; 472(1): 181-7. doi: 10.1007/s11999-013-3030-7.

Rockov Z A, Byrne C T, Rezzadeh K T, Durst C R, Spitzer A I, Paiement G D, et al. Revision total knee arthroplasty for arthrofibrosis improves range of motion. Knee Surg Sports Traumatol Arthrosc 2023; 31(5): 1859-64. doi: 10.1007/s00167-023-07353-8.

Dahlgren N, Lehtonen E, Anderson M, Archie A T, McGwin G, Shah A, et al. Readmission following revision total knee arthroplasty: an institutional cohort. Cureus 2018; 10(11): e3640. doi: 10.7759/cureus.3640.

Te Molder M E M, Verhoef L M, Smolders J M H, Heesterbeek P J C, van den Ende C H M. Prioritization of adverse consequences after total knee arthroplasty contributing to a poor response: a best–worst scaling exercise among total knee arthroplasty patients and knee specialists. J Arthroplasty 2024; 39(3): 651-7.e1. doi: 10.1016/j.arth.2023.08.060.

Archunan M, Swamy G, Ramasamy A. Stiffness after total knee arthroplasty: prevalence and treatment outcome. Cureus 2021; 13(9): e18271. doi: 10.7759/cureus.18271.

Haffar A, Goh G S, Fillingham Y A, Torchia M T, Lonner J H. Treatment of arthrofibrosis and stiffness after total knee arthroplasty: an updated review of the literature. Int Orthop 2022; 46(6): 1253-79. doi: 10.1007/s00264-022-05344-x.

Dutch Arthroplasty Register (LROI). Online LROI annual report 2023. ‘s-Hertogenbosch, The Netherlands: LROI; 2023. Available from: https://www.lroi-report.nl/data-quality/completeness/#Completeness-per-year

LROI. Knie Revisie: LROI. Available from: https://www.lroi.nl/media/wbwbtlwo/knie-revisie-20211108.pdf

R Core Development Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2010.

Lewis P L, A W D, Robertsson O, Prentice H A, Graves S E. Impact of patient and prosthesis characteristics on common reasons for total knee replacement revision: a registry study of 36,626 revision cases from Australia, Sweden, and USA. Acta Orthop 2022; 93: 623-33. doi: 10.2340/17453674.2022.3512.

Kee J R, Mears S C, Edwards P K, Barnes C L. Modifiable risk factors are common in early revision hip and knee arthroplasty. J Arthroplasty 2017; 32(12): 3689-92. doi: 10.1016/j.arth.2017.07.005.

Bongers J, Belt M, Spekenbrink-Spooren A, Smulders K, Schreurs B W, Koeter S. Smoking is associated with higher short-term risk of revision and mortality following primary hip or knee arthroplasty: a cohort study of 272,640 patients from the Dutch Arthroplasty Registry. Acta Orthop 2024; 95: 114-20. doi: 10.2340/17453674.2024.39966 .

Cheuy V A, Foran J R, Paxton R J, Bade M J, Zeni J A, Stevens-Lapsley J E. Arthrofibrosis associated with total knee arthroplasty. J Arthroplasty 2017; 32(8): 2604-11. doi: 10.1016/j.arth.2017.02.005.

Faust I, Traut P, Nolting F, Petschallies J, Neumann E, Kunisch E, et al. Human xylosyltransferases: mediators of arthrofibrosis? New pathomechanistic insights into arthrofibrotic remodeling after knee replacement therapy. Sci Rep 2015; 5: 12537. doi: 10.1038/srep12537.

Cohen J S, Gu A, Lopez N S, Park M S, Fehring K A, Sculco P K. Efficacy of revision surgery for the treatment of stiffness after total knee arthroplasty: a systematic review. J Arthroplasty 2018; 33(9): 3049-55. doi: 10.1016/j.arth.2018.04.036.

Shoji H, Solomonow M, Yoshino S, D’Ambrosia R, Dabezies E. Factors affecting postoperative flexion in total knee arthroplasty. Orthopedics 1990; 13(6): 643-9. doi: 10.3928/0147-7447-19900601-08.

Briggs M S, Ulses C, VanEtten L, Mansfield C, Ganim A, Hand B N, et al. Predictive factors for patients’ failure to show for initial outpatient physical therapist evaluation. Phys Ther 2021; 101(5): pzab047. doi: 10.1093/ptj/pzab047.

Armitstead J. An evaluation of initial non-attendance rates for physiotherapy. Physiotherapy 1997; 83(11): 591-6. doi: 10.1016/S0031-9406(05)65968-8.

van Steenbergen L N, Denissen G A, Spooren A, van Rooden S M, van Oosterhout F J, Morrenhof J W, et al. More than 95% completeness of reported procedures in the population-based Dutch Arthroplasty Register. Acta Orthop 2015; 86(4): 498-505. doi: 10.3109/17453674.2015.1028307.

Thompson R, Novikov D, Cizmic Z, Feng J E, Fideler K, Sayeed Z, et al. Arthrofibrosis after total knee arthroplasty: pathophysiology, diagnosis, and management. Orthop Clin North Am 2019; 50(3): 269-79. doi: 10.1016/j.ocl.2019.02.005 .

Schroer W C, Berend K R, Lombardi A V, Barnes C L, Bolognesi M P, Berend M E, et al. Why are total knees failing today? Etiology of total knee revision in 2010 and 2011. J Arthroplasty 2013; 28(8 Suppl): 116-19. doi: 10.1016/j.arth.2013.04.056.

Published

2024-10-15

How to Cite

van de Ven , M. P. F., Bongers, J., Spekenbrink-Spooren, A., & Koëter, S. (2024). Factors associated with arthrofibrosis-related revision following 14,325 total or unicompartmental knee arthro-plasties: an analysis from the Dutch Arthroplasty Registry. Acta Orthopaedica, 95, 607–611. https://doi.org/10.2340/17453674.2024.41988