Use of non-steroidal anti-inflammatory drugs in year 1 following total knee arthroplasty and implant survival: a register-based cohort study

<p class="abstract">Even though minor degrees of heterotrophic ossification are common in total knee arthroplasty, it is of little clinical significance. But severe degrees of heterotrophic ossification are very rare after total knee arthroplasty. Here we discuss about a 70 years old woman who initially had excellent post-operative range of movements after cemented total knee arthroplasty, but later presented with knee pain, swelling and loss of range of movements after 3 months. X ray showed severe heterotrophic ossification around knee near the quadriceps tendon. She was treated conservatively with non-steroidal anti inflammatory drugs and physiotherapy. After a period of 3 months of physiotherapy, patient regained the lost range of movements and is currently under follow up for the past 1 year. Hence this case instantiates that even in cases of severe Heterotrophic Ossification after total knee arthroplasty, non-operative treatments such as physiotherapy with anti-inflammatory drugs should be the primary option to treat the stiffness before considering surgery.</p><p class="abstract"> </p>

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Robotic-arm assisted total knee arthroplasty improves early functional recovery and time to hospital discharge compared to conventional jig-based total knee arthroplasty: A prospective cohort study

10.31256/hsmr2018.65 ◽

2018 ◽

Author(s):

B Kayani ◽

◽

S Konan ◽

J Tahmassebi ◽

FS Haddad

Keyword(s):

Total Knee Arthroplasty ◽

Cohort Study ◽

Hospital Discharge ◽

Prospective Cohort Study ◽

Functional Recovery ◽

Knee Arthroplasty ◽

Prospective Cohort ◽

Robotic Arm ◽

Total Knee ◽

Early Functional Recovery

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Analysis of the relationship between surgeon procedure volume and complications after total knee arthroplasty using a propensity-matched cohort study

BMJ Surgery, Interventions, & Health Technologies ◽

10.1136/bmjsit-2020-000072 ◽

2021 ◽

Vol 3 (1) ◽

pp. e000072

Author(s):

Tosan Okoro ◽

Sebastian Tomescu ◽

J Michael Paterson ◽

Bheeshma Ravi

Keyword(s):

Total Knee Arthroplasty ◽

Cohort Study ◽

Relative Risk ◽

Knee Arthroplasty ◽

Deep Infection ◽

Matched Cohort ◽

Surgical Infection ◽

Matched Cohort Study ◽

Total Knee

ObjectivesThis study aimed to identify a threshold in annual surgeon volume associated with increased risk of revision (for any cause) and deep infection requiring surgery following primary elective total knee arthroplasty (TKA).DesignA propensity score matched cohort study.SettingOntario, Canada.Participants169 713 persons who received a primary TKA between 2002 and 2016, with 3-year postoperative follow-up.Main outcome measuresRevision arthroplasty (for any cause), and the occurrence of deep surgical infection requiring surgery.ResultsBased on restricted cubic spline analysis, the threshold for increased probability of revision and deep infection requiring surgery was <70 cases/year. After matching of 51 658 TKA recipients from surgeons performing <70 cases/year to TKA recipients from surgeons with greater than 70 cases/year, patients in the former group had a higher rate of revision (for any cause, 2.23% (95% Confidence Interval (CI) 1.39 to 3.07) vs 1.70% (95% CI 0.85 to 2.55); Hazard Ratio (HR) 1.33, 95% CI 1.21 to 1.47, p<0.0001) and deep infection requiring surgery (1.29% (95% CI 0.44 to 2.14) vs 1.09% (95% CI 0.24 to 1.94); HR 1.33, 95% CI 1.17 to 1.51, p<0.0001).ConclusionsFor primary TKA recipients, cases performed by surgeons who had performed fewer than 70 TKAs in the year prior to the index TKA were at 31% increased relative risk of revision (for any cause), and 18% increased relative risk for deep surgical infection requiring surgery, at 3-year follow-up.

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