Komplikationen nach Knieprothesen-Implantation

Abstract

Complications after total knee arthroplasty were evaluated prospectively after a total of 321 procedures. 53 (16.5 %) patients showed postoperative courses deviating from the routine. Of these 5.0 % developed clinically relevant deep vein thromboses, the rate of deep infections was 1.6 %, 3.7 % of the patients suffered from persisting or recurrent joint effusions, arthrofibrosis was observed in 4.4 % of the patients and 1.9 % were affected by wound complications. In most patients deep infections were treated by removal of the implants and reimplantation after clearing of the infection. The primary treatment of arthrofibrosis consisted of manipulation under general or regional anaesthesia. Patients with recurrent joint effusions received punctions, which had to be repeated in some cases. In one patient an intraarticular drainage had to be inserted. The conservative or surgical therapy of wound complications depended on the patient's situation. In patients with thrombosis distal to the trifurcation of the popliteal vein anticoagulation with heparin was continued. In contrast, in patients with femoral or popliteal venous thrombosis the anticoagulation was changed to cumarine derivates.

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

“…Arthrofibrosis is usually an inflammatory, progressive fibrous process. After total knee arthroplasty, it occurs with a probability of up to 10% [5, 10–12]. In our patients collective, it was conspicuous that arthroscopy had been performed in 12 out of 19 patients (63.2%) before primary knee arthroplasty.…”