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International Orthopaedics
Published in: International Orthopaedics 10/2016

Open Access 01-10-2016 | Review Article

Conversion from knee arthrodesis to arthroplasty: systematic review

Authors: Willem Alexander Kernkamp, Wiebe Christiaan Verra, Bart Godefridus Pijls, Jan Wilhelmus Schoones, Henrica Maria Jannetta van der Linden, Rob Gerardus Henricus Hubertus Nelissen

Published in: International Orthopaedics | Issue 10/2016

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Abstract

Purpose

Arthrodesis (AD) of the knee reduces pain and provides stability, but has severe functional and social limitations. There has been ample discussion on the value of a conversion of an AD to a total knee arthroplasty (TKA). The aim of this study was to perform a review and meta-analysis of the current literature on conversion of an AD to TKA and assess clinical outcome, complication rate, surgical technique and overall patient-related outcome measures.

Methods

PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, Academic Search Premier, ScienceDirect and searching by hand for papers on conversion of AD of the knee to TKA. Two reviewers independently reviewed all titles and abstracts, and extracted the available data. Study eligibility criteria were: conversion of knee AD to TKA, five cases or more and non-oncology patients. Data consisted of study characteristics, patient demographics, clinical outcome and complications. Additionally, details on surgical technique were reviewed.

Results

Of the 866 unique references identified, six papers were included for further analyses, comprising a total of 123 knees with conversion of AD of the knee to TKA. Mean gain of knee flexion was 80 degrees and the mean HSS score improved with 20 points. A complicated postoperative course was found in 65 % of all cases. The most frequent complication was skin necrosis (25 %), followed by arthrofibrosis (13 %), infection (11 %) and revision (11 %). Major complications such as refusion, amputation and death occurred in less than 5 % of all cases.

Discussion

The majority of the papers consisted of small case series of moderate methodological quality, resulting in 123 included knees. Further series are necessary to draw definitive conclusions.

Conclusions

This is the first systematic review and meta-analysis on conversion of a knee arthrodesis to TKA. Good clinical results can be expected after conversion, albeit at a high risk of postoperative complications.
Appendix
Available only for authorised users
Literature
1.
Conway JD, Mont MA, Bezwada HP (2004) Arthrodesis of the knee. J Bone Joint Surg Am 86-a(4):835–848PubMed
2.
3.
Kim YH, Oh SH, Kim JS (2003) Conversion of a fused knee with use of a posterior stabilized total knee prosthesis. J Bone Joint Surg Am 85-a(6):1047–1050PubMed
4.
Cameron HU, Hu C (1996) Results of total knee arthroplasty following takedown of formal knee fusion. J Arthroplast 11(6):732–737CrossRef
5.
Clemens D, Lereim P, Holm I, Reikeras O (2005) Conversion of knee fusion to total arthroplasty: complications in 8 patients. Acta Orthop 76(3):370–374PubMed
6.
7.
Henkel TR, Boldt JG, Drobny TK, Munzinger UK (2001) Total knee arthroplasty after formal knee fusion using unconstrained and semiconstrained components: a report of 7 cases. J Arthroplast 16(6):768–776. doi:10.​1054/​arth.​2001.​24375 CrossRef
8.
Ruggieri P, Kasimatis G, Errani C, Bosco G, Mercuri M (2010) Desarthrodesis and prosthetic reconstruction of the knee after resection of bone tumors. J Surg Oncol 102(7):832–837. doi:10.​1002/​jso.​21726 CrossRefPubMed
9.
10.
Cermak K, Baillon B, Tsepelidis D, Vancabeke M (2013) Total knee arthroplasty after former knee fusion in a patient with Ehlers Danlos syndrome. Acta Orthop Belg 79(3):347–350PubMed
11.
Mahomed N, McKee N, Solomon P, Lahoda L, Gross AE (1994) Soft-tissue expansion before total knee arthroplasty in arthrodesed joints. A report of two cases. J Bone Joint Surg (Br) 76(1):88–90
12.
Naranja RJ Jr, Lotke PA, Pagnano MW, Hanssen AD (1996) Total knee arthroplasty in a previously ankylosed or arthrodesed knee. Clin Orthop Relat Res 331:234–237CrossRefPubMed
13.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clin Res Ed) 339:b2700. doi:10.​1136/​bmj.​b2700 CrossRef
14.
Pijls BG, Dekkers OM, Middeldorp S, Valstar ER, van der Heide HJ, Van der Linden-Van der Zwaag HM, Nelissen RG (2011) AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty. BMC Musculoskelet Disord 12:173. doi:10.​1186/​1471-2474-12-173 CrossRefPubMedPubMedCentral
15.
16.
17.
18.
Viechtbauer W (2010) Conducting meta-analyses in R with the metafor package. J Stat Softw 36(33):31–48
19.
Colditz GA, Brewer TF, Berkey CS, Wilson ME, Burdick E, Fineberg HV, Mosteller F (1994) Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature. JAMA 271(9):698–702CrossRefPubMed
20.
Kreder HJ, Williams JI, Jaglal S, Axcell T, Stephen D (1999) A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement. Can J Surg 42(6):433–439PubMedPubMedCentral
Metadata
Title
Conversion from knee arthrodesis to arthroplasty: systematic review
Authors
Willem Alexander Kernkamp
Wiebe Christiaan Verra
Bart Godefridus Pijls
Jan Wilhelmus Schoones
Henrica Maria Jannetta van der Linden
Rob Gerardus Henricus Hubertus Nelissen
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 10/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3150-2

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