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Soft Tissue Complications After Total Knee Arthroplasty

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Knee Surgery

Abstract

Of paramount importance to a successful total knee arthroplasty (TKA) is successful wound healing. Unfortunately, this is not always possible, and thus the goals of rapid rehabilitation and patient mobilization are not always achieved. Wound failure can lead to prosthesis infection, numerous surgical procedures, as well as an extended hospitalization. The patient’s and surgeon’s expectations are not met and frustration can occur for all parties involved.

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References

  1. Scapinelli R. Studies on the vasculature of the human knee. Acta Anat 1968; 70: 305–331.

    Article  PubMed  CAS  Google Scholar 

  2. Craig SM. Soft tissue considerations in the failed total knee arthroplasty. In: Scott WN (ed). The Knee, vol 2. St. Louis: Mosby-Yearbook, 1994: 1279–1295.

    Google Scholar 

  3. Abbott LC, Carpenter WF. Surgical approaches to the knee joint. J Bone Joint Surg 1945; 27: 277–310.

    Google Scholar 

  4. Bjorkstrom S, Goldie IF. A study of the arterial supply of the patellae in the normal state, in chondromalacia patellae and in osteonecrosis. Acta Orthop Scand 1980; 51: 63–70.

    Article  PubMed  CAS  Google Scholar 

  5. Waisbrod H, Treiman N. Intra-osseous venography in patellofemoral disorders: a preliminary report. J Bone Joint Surg 1980; 62B: 454–456.

    Google Scholar 

  6. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 1987; 40: 113.

    Article  PubMed  CAS  Google Scholar 

  7. Arey LB. Wound healing. Physiol Reu 1966; 16: 327.

    Google Scholar 

  8. Glenn F, Moore SW. The disruption of abdominal wounds. Surg Gynecol Obstet 1941; 72: 1041.

    Google Scholar 

  9. Heughan C, Chir B, Grislis G, Hunt JK. The effect of anemia on wound healing. Ann Surg 1974; 179: 163.

    Article  PubMed  CAS  Google Scholar 

  10. Johnson DD, Eastwood DM. Lateral patellar release in knee arthroplasty: effect on wound healing. J Arthroplasty 1992; 7 (suppl): 407–431.

    Google Scholar 

  11. Archauer BM, Black KS, Litke DK. Transcutaneous p02 in flaps: a new method of survival prediction. Plast Reconst Surg 1980; 65: 738–745.

    Article  Google Scholar 

  12. Ecker ML, Lotke PA. Postoperative care of the total knee patient. Orthop Clin North Am 1989; 20: 55–62.

    CAS  Google Scholar 

  13. Dickhaut SC, DeLee JL, Pase CP. Nutritional statistics. Importance in predicting wound healing after amputation. J Bone Joint Surg 1984; 66A: 71–75.

    PubMed  CAS  Google Scholar 

  14. Wilson MG, Kelley K, Thornhill TS. Infection as a complication of total knee replacement arthroplasty: risk factors and treatment in sixty-seven cases. J Bone Joint Surg 1990; 72A: 878–883.

    CAS  Google Scholar 

  15. Cruse PJ, Foord R. A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973; 107: 206210.

    Google Scholar 

  16. Benowitz NL, Jacob P III. Daily intake of nicotine during cigarette smoking. Clin Pharmacol Ther 1984; 35: 494.

    Article  Google Scholar 

  17. Benowitz NL, Koyt F, Jacob P. Influence of nicotine on cardiovascular and hormone effects of cigarette smoking. Clin Pharmacol Ther 1984; 36: 74.

    CAS  Google Scholar 

  18. Benowitz NL, Kuyt F, Jacob P 3d, et al. Cotinine disposition and effects. Clin Pharmacol Ther 1983; 34: 664.

    Article  Google Scholar 

  19. Klein NE, Cox LU. Wound problems in total knee arthroplasty. In: Fu FH, Harner CD, Vince KG, et al (eds). Knee Surgery, vol 2. Baltimore: Williams and Wilkins, 1994: 1539–1552.

    Google Scholar 

  20. Green JP. Steroid therapy and wound healing in surgical patients. Br J Surg 1965; 52: 523–525.

    Article  PubMed  CAS  Google Scholar 

  21. Wahl LM. Hormonal resolution of macrophage collage-nase activity. Biochem Biophys Res Commun 1977; 74: 838–845.

    Article  PubMed  CAS  Google Scholar 

  22. Werb Z. Biochemical actions of glucocorticoids on macrophages in culture. J Exp Med 1978; 147 (6): 1695–1712.

    Article  PubMed  CAS  Google Scholar 

  23. Soft Tissue Complications After Total Knee Arthroplasty 427

    Google Scholar 

  24. Garner RW, Mowot AG, Hazleman BL. Wound healing after operations on patients with rheumatoid arthritis. J Bone Joint Surg 1973; 55B (1): 134–144.

    CAS  Google Scholar 

  25. Grogan TJ, Dores F, Rolling J, Amstutz HC. Deep sepsis following total knee arthroplasty. J Bone Joint Surg 1986; 68A (2): 226–234.

    CAS  Google Scholar 

  26. Dennis PA. Wound complications in total knee arthroplasty. Inst Course Lect 1997; 46: 165–169.

    CAS  Google Scholar 

  27. Gold DA, Scott SC, Scott WN. Soft tissue expansion prior to arthroplasty in the multiply operated knee-a new method of preventing catastrophic skin problems. J Arthroplasty 1996; 11 (5): 512–521.

    Article  PubMed  CAS  Google Scholar 

  28. Santore RF, Kaufman D, Robbins AJ, Dabezies EJ. Tissue expansion prior to revision total knee arthroplasty. J Arthroplasty 1997; 12 (4): 475–478.

    Article  PubMed  CAS  Google Scholar 

  29. Namba RS, Diao E. Tissue expansion for staged reim-plantation of infected total knee arthroplasty. J Arthroplasty 1997; 12 (4): 471–474.

    Article  PubMed  CAS  Google Scholar 

  30. Riederman R, Noyes FR. Soft tissue skin expansion of contracted tissues prior to knee surgery. Am J Knee Surg 1991; 4 (4): 195–199.

    Google Scholar 

  31. Johnson DD. Midline or parapatellar incision for knee arthroplasty. A comparative study of wound inability. J Bone Joint Surg 1988; 70B (4): 656–658.

    CAS  Google Scholar 

  32. Johnson DD, Houshton TA, Redford P. Anterior midline or medial parapatellar incision for arthroplasty of the knee. A comparative study. J Bone Joint Surg 1986; 68B (5): 812–814.

    CAS  Google Scholar 

  33. Ecker ML, Lotke PA. Wound healing complications. In: Rand JA (ed). Total Knee Arthroplasty. New York: Raven Press, 1993: 403–407.

    Google Scholar 

  34. Windsor RE, Insall JN, Vince KE. Technical consideration of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg 1988; 70A: 547–555.

    PubMed  CAS  Google Scholar 

  35. Casha JN. Suture reaction following skin closure with sub-cuticular polydionanone in total knee arthroplasty. J Arthroplasty 1996; 11 (7): 859–861.

    Article  PubMed  CAS  Google Scholar 

  36. Rosenberg AG. Surgical technique of posterior cruciate sacrificing and preserving total knee arthroplasty. In: Rand JA (ed). Total Knee Arthroplasty. New York: Lippincott-Raven, 1993: 115.

    Google Scholar 

  37. Rothause KO. Plastic and reconstructive surgery. In: Insall JN (ed). Surgery of the Knee, vol 2. New York: Churchill-Livingstone, 1993: 1200–1201.

    Google Scholar 

  38. Johnson DD. The effect of continuous passive motion on wound healing and joint mobility after total knee arthroplasty. J Bone Joint Surg 1990; 78 (A): 421–426.

    Google Scholar 

  39. Yashar AA. Continuous passive motion with accelerated flexion after total knee arthroplasty. Clin Orthop 1997; 345: 38–43.

    Google Scholar 

  40. Faralli VJ, Lotke PA, Orenstein E. Blood loss after total knee replacement: effects of early motion. Paper presented at the 55th annual meeting of AAOS, February 1988.

    Google Scholar 

  41. Abdel-Salam A, Eyres KS. Effects of tourniquet during total knee arthroplasty. A prospective randomized study. J Bone Joint Surg 1995; 77B (2): 250–253.

    CAS  Google Scholar 

  42. Holt BT, Parks NL, Ensh GA, Lawrence JM. Comparison of closed suction drainage and no drainage after primary total knee arthroplasty. Orthopaedics 1997; 20 (12): 1121–1124.

    CAS  Google Scholar 

  43. Crevoisier XM, Reber P, Noesberger B. Is suction drainage necessary after total joint arthroplasty? A prospective study. Arch Orthop Trauma Surg 1998; 117 (3): 121–124.

    Article  CAS  Google Scholar 

  44. Ovadin D, Luger E, Bickels J, Menachem A, Dekel S. Efficacy of closed wound drainage after total joint arthroplasty. A prospective randomized study. J Arthroplasty 1997; 12 (3): 317–321.

    Article  Google Scholar 

  45. Drinkwater CJ, Neil MJ. Optimal timing of wound drain removal following total joint arthroplasty. J Arthroplasty 1995; 10 (2): 185–189.

    Article  PubMed  CAS  Google Scholar 

  46. Stulberg BN, Insall JN, Williams GW, Ghelman B. Deep vein thrombosis following total knee replacement. J Bone Joint Surg 1984; 66A (2): 194–201.

    PubMed  CAS  Google Scholar 

  47. Levine MN, Gent M, Hirsh J, et al. Ardeparin (low molecular weight heparin) vs. graduated compression stockings for the prevention of venous thromboembolism. A randomized trial in patients undergoing knee surgery. Arch Intern Med 1996; 156: 851–856.

    CAS  Google Scholar 

  48. Leclerc JR, Geerts WN, DesJardins L, et al. Prevention of venous thromboembolism (WTE) after knee arthroplasty-a randomized double-blind trial comparing a low molecular-weight heparin fragment (Enoxaparin) to warfarin. Blood 1992; 84: 246a.

    Google Scholar 

  49. Spiro TE, Fitzgerald RH, Trowbridge AA, et al. Enoxaparin-a low molecular weight heparin and warafin for the prevention of venous thromboembolic disease after elective knee replacement surgery. Blood 1994; 84: 246a.

    Google Scholar 

  50. Weiss AP, Krackow KA. Persistent wound drainage after primary total knee arthroplasty. J Arthroplasty 1993; 8: 285–289.

    Article  PubMed  CAS  Google Scholar 

  51. Bergstrom S, Krutson K, Lidgren L. Treatment of infected knee arthroplasty. Clin Orthop 1989; 245: 173–178.

    Google Scholar 

  52. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg 1980; 62A: 1329–1337.

    PubMed  CAS  Google Scholar 

  53. Sculco TP. Local wound complications after total knee arthroplasty. In: Ranawat C (ed). Total Condylar Knee Arthroplasty: Technique, Results and Complications. New York: Springer-Verlag, 1985: 194–196.

    Chapter  Google Scholar 

  54. Hallock GG. Salvage of total knee arthroplasty with local fasciocutaneous flaps. J Bone Joint Surg 1990; 72 (B): 1236–1239.

    CAS  Google Scholar 

  55. Bergstrom S, Carlsson A, Relander M, Kuntson K, Lindgren L. Treatment of the exposed knee prosthesis. Acta Orthop Scand 1987; 58: 662–665.

    Article  Google Scholar 

  56. F.D. Cushner, S.C. Scott, and W.N. Scott

    Google Scholar 

  57. Eckhardt JJ, Lesavoy MA, Dubrow TJ, Wackyum PA. Exposed endo-prosthesis. Clin Orthop 1990; 251: 220229.

    Google Scholar 

  58. Hemphill CS, Ebert FR, Muench AG. The medial gastrocnemius muscle flap in the treatment of wound complications following total knee arthroplasty. Orthopaedics 1992; 15 (4): 477–480.

    CAS  Google Scholar 

  59. Peled IJ, Franki U, Wexler MR. Salvage of exposed knee prosthesis by gastrocnemius myocutaneous flap coverage. Orthopedics 1983; 6 (10): 1320–1322.

    Google Scholar 

  60. Salibian AH, Sanford HA. Salvage of an infected total knee prosthesis with medial and lateral gastrocnemius muscle flaps. J Bone Joint Surg 1983;65A(5):681684.

    Google Scholar 

  61. Gerwin M, Rothaus KU, Windsor RE, et al. Gastrocnemius muscle flap coverage of exposed or infected knee prosthesis. Clin Orthop 1993; 286: 64–70.

    PubMed  Google Scholar 

  62. Markovich G, Dorr LD, Klein NE, McPherson EJ, Vince KG. Muscle flaps in knee arthroplasty. Clin Orthop 1995; 321: 122–130.

    PubMed  Google Scholar 

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Authors
  1. Fred D. Cushner
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  2. Susan Craig Scott
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  3. W. Norman Scott
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Editor information

Editors and Affiliations

  1. Tyson’s Professional Building, Washington Orthopaedic and Knee Clinic, Inc., 8206 Lessburg Pike, #201, 22182, Vienna, VA, USA

    M. Mike Malek M.D.

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© 2001 Springer Science+Business Media New York

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Cushner, F.D., Scott, S.C., Scott, W.N. (2001). Soft Tissue Complications After Total Knee Arthroplasty. In: Malek, M.M. (eds) Knee Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-87202-0_31

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  • DOI: https://doi.org/10.1007/978-3-642-87202-0_31

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-87204-4

  • Online ISBN: 978-3-642-87202-0

  • eBook Packages: Springer Book Archive

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