2015
DOI: 10.1038/srep16469
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Fibrosis is a common outcome following total knee arthroplasty

Abstract: Total knee arthroplasty (TKA) is one of the most successful orthopaedic procedures that alleviates pain and restores function in patients with degenerative knee joint diseases. Arthrofibrosis, abnormal scarring in which dense fibrous tissue prevents normal range of motion, develops in ~3–10% of TKA patients. No prophylactic intervention is available and treatment is restricted to aggressive physiotherapy or revision surgery. Tissue was collected from patients undergoing primary (n = 30) or revision (n = 27) TK… Show more

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Cited by 81 publications
(83 citation statements)
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“…Stiffness and joint fibrosis is a significant problem following TKA. We have previously shown that fibrotic, dense collagenous scar tissue is found in all patients undergoing aseptic revision surgery for failed primary TKA . The fibrotic tissue is characterized by the deposition of a dense, disorganized extracellular matrix of collagen populated by myofibroblasts .…”
Section: Discussionmentioning
confidence: 71%
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“…Stiffness and joint fibrosis is a significant problem following TKA. We have previously shown that fibrotic, dense collagenous scar tissue is found in all patients undergoing aseptic revision surgery for failed primary TKA . The fibrotic tissue is characterized by the deposition of a dense, disorganized extracellular matrix of collagen populated by myofibroblasts .…”
Section: Discussionmentioning
confidence: 71%
“…Data presented in this report suggest that the levels of key biologically active pro‐inflammatory mediators are locally elevated at time of revision surgery many years after the initial procedure in failed TKAs. The painful, fibrotic post‐TKA joint acquires a state of unresolved inflammation with a signature resembling that of a chronic allergic reaction . Markers with this temporal regulation include those involved in matrix formation (VEGF, Flt‐1) and the inflammatory cytokines GM‐CSF, IL‐5 and IL‐8, and cell recruitment chemokines CCL2, CCL3 and CCL4.…”
Section: Discussionmentioning
confidence: 99%
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“…There are multiple post-operative interventions suggested to prevent stiffness from occurring [6]. However, with greater understanding of fibrosis pathways there may be inhibitors that may stop the post-operative stiffness from developing [1], which may improve the patients functional outcome and satisfaction.…”
Section: Discussionmentioning
confidence: 99%
“…Fibrosis often develops after joint trauma or major surgical procedures such as total knee arthroplasty (TKA) and anterior cruciate ligament (ACL) reconstruction . Approximately, 3–10% of TKA patients are treated for arthrofibrosis, while 2–35% of ACL reconstruction patients and 14.5% of patients with knee intra‐articular fractures require intervention . The standard‐of‐care is limited to arthroscopic debridement, capsule‐release, and manipulating limbs under anesthesia.…”
mentioning
confidence: 99%