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

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.

Supplementary Information:

The online version contains supplementary material available at 10.1007/s43465-022-00709-1.

• Authors: Nina D Fisher, Kenneth A Egol, Ran Schwarzkopf
• Journal: Indian journal of orthopaedics (Indian J Orthop) Vol. 56 Issue 10 Pg. 1751-1758 (Oct 2022) ISSN: 0019-5413 [Print] Switzerland
• PMID: 36187592 (Publication Type: Journal Article)
• Copyright: © Indian Orthopaedics Association 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.