Our Summary

Arthrodesis, a knee surgery, helps to reduce pain and provide stability, but it can also lead to serious functional and social limitations. As a result, there has been debate about the benefits of converting an arthrodesis to a total knee arthroplasty (TKA), which is a type of knee replacement. This study aimed to review and analyze existing research on the conversion from arthrodesis to TKA, focusing on patient outcomes, complication rates, surgical techniques, and overall patient-related outcome measures.

A total of 866 research papers were initially identified, but only six were included in the final review, covering 123 knees that had been converted from arthrodesis to TKA. On average, knee flexibility increased by 80 degrees and patient’s health scores improved by 20 points following the conversion. However, 65% of all cases experienced complications after surgery, including skin necrosis, joint fibrosis, infection, and the need for further surgery. Serious complications such as fusion of the joint, amputation, or death occurred in less than 5% of cases.

The researchers concluded that good clinical results can be expected when an arthrodesis is converted to a TKA, but there is a high risk of postoperative complications. The researchers also noted that the studies included in their review were mostly small case series of moderate quality, and further research is needed to reach more definitive conclusions.

FAQs

  1. What is the difference between arthrodesis and total knee arthroplasty (TKA)?
  2. What are the potential complications after converting an arthrodesis to a TKA?
  3. What were the conclusions drawn from the research on the conversion from arthrodesis to TKA?

Doctor’s Tip

Therefore, if you are considering converting your arthrodesis to a total knee arthroplasty, it is important to discuss the potential benefits and risks with your healthcare provider. They can provide you with personalized advice based on your specific situation and help you make an informed decision about the best treatment option for you. It is also important to follow your doctor’s postoperative instructions carefully to reduce the risk of complications and ensure a successful recovery.

Suitable For

Patients who are typically recommended for knee replacement surgery include those with severe knee pain that limits daily activities, arthritis that has not responded to other treatments, knee deformity, or significant joint damage. Additionally, patients who have had a previous knee surgery such as arthrodesis and are experiencing limitations in function and mobility may be candidates for conversion to a total knee arthroplasty. However, it is important for patients to discuss the risks and benefits of the procedure with their healthcare provider to determine if knee replacement is the best option for them.

Timeline

Before knee replacement:

  • Patient experiences chronic knee pain, stiffness, and limited mobility
  • Patient undergoes various non-surgical treatments such as medication, physical therapy, and injections
  • If non-surgical treatments are ineffective, patient may be recommended for knee replacement surgery

After knee replacement:

  • Patient undergoes pre-operative assessments and preparation for surgery
  • Patient undergoes knee replacement surgery, where damaged knee joint is replaced with an artificial implant
  • Patient begins post-operative rehabilitation, including physical therapy and exercise to regain strength and mobility
  • Patient gradually resumes daily activities and experiences reduced pain and improved function in the replaced knee

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement include:

  1. What are the potential benefits of converting my arthrodesis to a total knee arthroplasty (TKA)?
  2. What are the potential risks and complications associated with this surgery?
  3. How experienced are you in performing conversions from arthrodesis to TKA?
  4. What is the typical recovery process and timeline for this type of surgery?
  5. Are there any alternative treatments or procedures that I should consider before deciding on a conversion to TKA?
  6. How will my mobility and quality of life be impacted after the surgery?
  7. Are there any specific rehabilitation or physical therapy programs that I should follow post-surgery?
  8. What is the long-term outlook for patients who have undergone a conversion from arthrodesis to TKA?
  9. How often will I need follow-up appointments or monitoring after the surgery?
  10. Are there any lifestyle changes or precautions I should take to ensure the success of the surgery and minimize complications?

Reference

Authors: Kernkamp WA, Verra WC, Pijls BG, Schoones JW, van der Linden HM, Nelissen RG. Journal: Int Orthop. 2016 Oct;40(10):2069-2074. doi: 10.1007/s00264-016-3150-2. Epub 2016 Mar 16. PMID: 26980621