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Risk Factors for Wound Complications Following Conversion TKA after Tibial Plateau Fracture

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Abstract

Introduction

The purpose is to investigate the incidence of wound complications for total knee arthroplasty (TKA) following tibial plateau open reduction and internal fixation (ORIF).

Materials and Methods

A prospective arthroplasty registry was queried for patients with CPT codes for primary TKA, tibial plateau ORIF, removal of hardware (ROH), and diagnosis of post-traumatic arthritis. Patients were included if they had undergone tibial plateau ORIF and subsequent TKA. Chart review was performed to obtain demographic, clinical and post-operative information.

Results

Twenty-one patients were identified, with average age of 56.23 ± 13.2 years at time of tibial plateau ORIF and 62.91 ± 10.8 years at time of TKA. Seven (33.3%) patients had a tibial plateau fracture-related infection (FRI). Eight (38.1%) patients underwent ROH prior to TKA. Seven (33.3%) patients’ TKA incision incorporated the prior plateau incisions. Eight (36.4%) patients developed wound complications following TKA and 5 (23.8%) developed an acute periprosthetic joint infection (PJI) following TKA and had the plateau incision incorporated into the TKA incision. FRI history did not increase the rate of wound complications but did increase the rate of ROH prior to TKA.

Conclusions

Previous FRI involving tibial plateau repair surgery doesn’t correlate with PJI after conversion TKA for post traumatic OA. Surgeon-controlled factors such as staged ROH and incision placement can help reduce the rate of wound complications following TKA performed after tibial plateau ORIF.

Level of Evidence

Prognostic Level IV.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. NYU Langone Orthopedic Hospital, 301 E 17th St, Suite 1402, New York, NY, 10003, USA

    Nina D. Fisher, Kenneth A. Egol & Ran Schwarzkopf

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  1. Nina D. Fisher
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  2. Kenneth A. Egol
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  3. Ran Schwarzkopf
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Correspondence to Nina D. Fisher.

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Dr Nina Fisher has no relevant financial or non-financial interests to disclose. Dr Kenneth Egol is a consultant for Exactech and Synthes, receives royalties from Exactech, Wolters Kluwer and Slack Inc, receives research support from Synthes and Acumed, and is a paid lecturer for Smith & Nephew. Dr Ran Schwarzkopf receives royalties from Smith & Nephew, is a paid consultant for Smith & Nephew and Intellijoint, has stocks in Intellijoint, receives research support from Smith & Nephew and Intellijoint, is on the editorial board of the Journal of Arthroplasty and Arthroplasty Today and is a board member of AAHKS and AAOS.

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Fisher, N.D., Egol, K.A. & Schwarzkopf, R. Risk Factors for Wound Complications Following Conversion TKA after Tibial Plateau Fracture. JOIO 56, 1751–1758 (2022). https://doi.org/10.1007/s43465-022-00709-1

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  • DOI: https://doi.org/10.1007/s43465-022-00709-1

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