Abstract

Background: Knee arthroplasty is one of the most common and successful surgeries for osteoarthritis patient. It vary depending on which compartment need to be replaced to total and partial knee arthroplasty.  The purpose of this review was to discuss some of the most common reported complications following TKA that lead to revisions,  to explore the causes behind these complications and to summarise some of the current recommendation for postoperative monitoring.

Method: Electronic databases (Web of science, Google scholar and PubMed) were searched to study the literature for articles related to the complications following total knee arthroplsaty.  The search within these databases were limited from 2000 to 2018.

Results: Infection, aseptic loosening, instability, polyethylene wear, malalignment and malposition, arthrofibrosis, extensor mechanism deficiency, pain, periprosthetic fracture and avascular necrosis in the patella were the most common reported complications the led to revision surgeries.

Conclusion: Different factors can contribute in developing  complications after TKA. These factors can be related to the surgery, patient or implant. A thorough Understanding of the causes of these complications, providing training with qualified and expert surgeons as well as improving implants manufacturing can contribute significantly in the success of TKA.

(Abstract words count 190)

Introduction

Knee arthroplasty or knee replacement is one of the most common and successful surgeries for end stage osteoarthritis. In 2010, the prevalence of knee replacement in the United States was 10.38% (4.7 million individuals with knee replacement) (Maradit Kremers et al., 2015).   There are two different types of knee implants: total knee arthroplasty (TKA) and partial knee arthroplasty (PKA).  These implants vary depending on the affected compartments that need to be replaced. While partial knee replacement aims to replace the damaged bone and tissues, total knee arthroplasty aims to maintain the normal alignment of the knee. Furthermore, the method of fixation vary from cemented to uncemented fixation. Along with the increase in TKA surgeries, some  complications may occur intra-operatively or post-operatively. The purpose of this review is to discuss some of the common reported complications following TKA that lead to revisions,  to explore the causes behind these complications and to summarise some of the current recommendation for postoperative monitoring.

Methods

Web of science, Google scholar and PubMed electronic databases were searched to study the literature for the articles that had the following terms in the title: knee arthroplasty OR replacement, Knee replacement complications, total knee replacement failure and TKA revision. Furthermore, the search method included filtering the articles to minimize the search results. Only articles from the latest publications (2000 to 2018) were preferred.

Results

A total of 19 reference paper were selected.  Further,  six articles were chosen to study the most common complication following TKA that lead to revisions. According to these studies, the most common reported complications that lead to revisions are: infection, aseptic loosening, instability, polyethylene wear, malalignment and malposition, arthrofibrosis, extensor mechanism deficiency, pain, periprosthetic fracture and avascular necrosis in the patella.

Discussion