Extensor mechanism injury, infection, and an extended time between trauma and surgical approach are related to the need for total knee arthroplasty removal after traumatic dehiscence

Carregando...
Imagem de Miniatura
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER
Citação
KNEE, v.41, p.240-245, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Surgical wound-related traumatic complications are rarely reported in the lit-erature. Traumatic dehiscence is unpredictable because of the trauma magnitude and the potential of associated injuries. This study aims to report the clinical outcomes and com-plications of a case series due to traumatic dehiscence after total knee arthroplasty (TKA) and establish possible criteria for prognosis for maintaining the implant.Methods: Patients admitted to an emergency room due to traumatic dehiscence after TKA were retrospectively evaluated. Patient data was analyzed and patients who maintained or not the arthroplasty were compared to establish prognosis factors.Results: Thirty-two patients with traumatic dehiscence after TKA were evaluated. The trauma occurred on a mean of 14.3 +/-25.0 days after the surgical procedure, and debride-ment in the operating room was performed on a mean of 6.2 +/-4.9 hours after the trauma. Twenty patients maintained the arthroplasty until the end of follow-up and did not require revision. Factors related to arthroplasty removal were associated extensor mechanism injury (p = 0.026), time from trauma to surgical debridement (p = 0.035), and infection (p = 0.0001)Conclusion: Traumatic dehiscence after total knee arthroplasty is an event with a high rate of complications. Extensor mechanism Injury, infection, and extended time between trauma and surgical intervention were poor prognostic factors for arthroplasty maintenance.
Palavras-chave
Wound dehiscence, Knee arthroplasty, Wound complication, Periprosthetic joint infection, Revision knee arthroplasty
Referências
  1. Adelani MA, 2014, BONE JOINT J, V96B, P619, DOI 10.1302/0301-620X.96B5.33479
  2. Alghnam S, 2020, J FAM COMMUNITY MED, V27, P114, DOI 10.4103/jfcm.JFCM_245_19
  3. Angers M, 2019, ORTHOP TRAUMATOL-SUR, V105, P633, DOI 10.1016/j.otsr.2019.03.002
  4. Bovonratwet P, 2020, J ARTHROPLASTY, V35, P2451, DOI 10.1016/j.arth.2020.04.073
  5. Chan ACM, 2018, PHYS THER, V98, P767, DOI 10.1093/ptj/pzy071
  6. Frosch Petra, 2004, Acta Orthop Belg, V70, P565
  7. Helito CP, 2020, WOUNDS, V32, P142
  8. Helito CP, 2020, BMC MUSCULOSKEL DIS, V21, DOI 10.1186/s12891-020-03510-z
  9. Helito CP, 2014, CLINICS, V69, P735, DOI 10.6061/clinics/2014(11)05
  10. Kim J, 2020, INT J ENV RES PUB HE, V17, DOI 10.3390/ijerph17176097
  11. Kim JH, 2019, J ARTHROPLASTY, V34, P2804, DOI 10.1016/j.arth.2019.06.020
  12. Kim TW, 2021, J ARTHROPLASTY, V36, P93, DOI 10.1016/j.arth.2020.06.064
  13. Patel VP, 2007, J BONE JOINT SURG AM, V89A, P33, DOI 10.2106/JBJS.F.00163
  14. Sershon RA, 2018, J ARTHROPLASTY, V33, P2613, DOI 10.1016/j.arth.2018.02.090
  15. Simons MJ, 2017, J AM ACAD ORTHOP SUR, V25, P547, DOI 10.5435/JAAOS-D-15-00402
  16. Vince K, 2007, J ARTHROPLASTY, V22, P39, DOI 10.1016/j.arth.2007.03.014