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Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment.

Authors
  • Fournier, Gaspard1
  • Gaillard, Romain1
  • Swan, John1
  • Batailler, Cécile2
  • Lustig, Sébastien2
  • Servien, Elvire3
  • 1 Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence, 69004 Lyon, France. , (France)
  • 2 Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence, 69004 Lyon, France - Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, 69622 Lyon, France. , (France)
  • 3 Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence, 69004 Lyon, France - EA 7424 - Interuniversity Laboratory of Human Movement Science, Université Lyon 1, Lyon, France. , (France)
Type
Published Article
Journal
SICOT-J
Publication Date
Jan 01, 2021
Volume
7
Pages
35–35
Identifiers
DOI: 10.1051/sicotj/2021034
PMID: 34009119
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

One of the principal complications after total knee arthroplasty (TKA) is stiffness. There are no publications concerning stiffness after unicompartmental knee arthroplasty (UKA). Study objectives were to describe the incidence of stiffness after UKA, to look for risk factors, and to describe safe and effective arthroscopic treatment. There were 240 UKA performed between March 2016 and January 2019 included. Robotic-assisted surgery was performed in 164 patients and mechanical instrumentation in 76 patients. Stiffness was defined as flexion < 90° or a flexion contracture > 10° during the first 45 post-operative days. Patients with stiffness were treated with arthroscopic arthrolysis. Several factors were studied to look for risk factors of stiffness: body mass index, gender, age, mechanical or robotic instrumentation, preoperative flexion, previous meniscectomy, and anticoagulant treatment. Arthrolysis effectiveness was evaluated by flexion improvement and UKA revision rate. 22 patients (9%) developed stiffness. Mechanical instrumentation significantly increased the risk of stiffness with OR = 0.26 and p = 0.005. Robotic-assisted surgery decreased the risk of stiffness by five-fold. Before arthrolysis, mean knee flexion was 79°, versus 121° (53% improvement) after arthroscopic arthrolysis. Only 2 patients (9%) underwent UKA revision after arthrolysis. Stiffness after UKA is an important complication with an incidence of 9% in this study. Arthroscopic arthrolysis is a safe and effective treatment with a range of motion improvement of > 50%. Robotic-assisted surgery significantly decreases the risk of postoperative stiffness. Level III, therapeutic study, retrospective cohort study. © The Authors, published by EDP Sciences, 2021.

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