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The effect of losartan on range of motion and rates of manipulation in total knee arthroplasty: a retrospective matched cohort study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Arthrofibrosis remains a common cause of patient dissatisfaction and reoperation after total knee arthroplasty (TKA). Losartan is an angiotensin receptor blocker (ARB) with inhibitory effects on transforming growth factor beta, previously implicated in tissue repair induced fibrosis, and has been studied to prevent stiffness following hip arthroscopy. This study aimed to evaluate pre- and postoperative range of motion (ROM) and the incidence of manipulation under anesthesia (MUA) following primary TKA in patients taking Losartan preoperatively for hypertension.

Materials and methods

A retrospective review of 170 patients from 2012 to 2020 who underwent a primary, elective TKA and were prescribed Losartan at least three months prior to surgery. All patients who were prescribed Losartan and had a preoperative and postoperative ROM in their chart were included and were matched to a control group of patients who underwent TKA and had no Losartan prescription. ROM, MUA, readmissions, reoperations, and revisions were assessed using chi-square and independent sample t tests.

Results

Seventy-nine patients met the inclusion criteria. Preoperative ROM was similar between patients on Losartan and the control group (103.59° ± 16.14° vs. 104.59° ± 21.59°, respectively; p = 0.745). Postoperative ROM and ΔROM were greater for patients prescribed Losartan (114.29° ± 12.32° vs. 112.76° ± 11.65°; p = 0.429 and 10.57° ± 14.95° vs. 8.17° ± 21.68°; p = 0.422), though this difference did not reach statistical significance. There was no difference in readmission, rate of manipulation for stiffness, or all-cause revision rates.

Conclusion

In this study, we found that the use of Losartan did not significantly improve postoperative ROM, reduce MUA or decrease revision rates. Further prospective studies using Losartan are required to elucidate the potential effects on ROM and incidence of arthrofibrosis requiring MUA.

Level III evidence

Retrospective cohort study.

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Data availability

The data that support the findings of this study are available from the corresponding author, J.C.R, upon reasonable request.

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Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA

    Jerry Arraut, Vivek Singh, Benjamin Fiedler, Ran Schwarzkopf & Joshua C. Rozell

  2. Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra/Northwell, Huntington Hospital, Huntington, NY, USA

    Katherine A. Lygrisse

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  1. Jerry Arraut
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Corresponding author

Correspondence to Joshua C. Rozell.

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Conflict of interest

JA, KAL, VS and BF have nothing to disclose. RS reports being a board or committee member for AAOS and AAHKS, being part of the editorial or governing board for Arthroplasty Today and JOA, having stock and stock options in Gauss surgical and PSI, being a paid consultant and having stock or stock options in Intelijoint, and being a paid consultant and receiving IP royalties and research support from Smith and Nephew. JR reports being a board or committee member for NYSSO.

Ethical approval

Our Institutional Review Board (IRB) approved the present study.

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Informed consent was obtained from all individual participants included in the study.

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Arraut, J., Lygrisse, K.A., Singh, V. et al. The effect of losartan on range of motion and rates of manipulation in total knee arthroplasty: a retrospective matched cohort study. Arch Orthop Trauma Surg 143, 4043–4048 (2023). https://doi.org/10.1007/s00402-022-04696-8

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