Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study
Abstract The presence of heterotopic ossification (HO) after primary total knee replacement (TKR) is rare and associated with limited mobility and stiffness of the knee. This study aimed to identify if the arthroscopic debridement after TKR could decrease HO and improve the function and range of mot...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-03-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-56300-1 |
| _version_ | 1827316049590091776 |
|---|---|
| author | Dong-Liang Zhang Wei Zhang Yi-Ming Ren Wen-Jun Zhao He-Jun Sun Zheng-Wei Tian Meng-Qiang Tian |
| author_facet | Dong-Liang Zhang Wei Zhang Yi-Ming Ren Wen-Jun Zhao He-Jun Sun Zheng-Wei Tian Meng-Qiang Tian |
| author_sort | Dong-Liang Zhang |
| collection | DOAJ |
| description | Abstract The presence of heterotopic ossification (HO) after primary total knee replacement (TKR) is rare and associated with limited mobility and stiffness of the knee. This study aimed to identify if the arthroscopic debridement after TKR could decrease HO and improve the function and range of motion. Thirty HO patients after TKR were retrospectively separated into 2 cohorts. 15 patients of group A accepted the arthroscopic debridement, while 15 patients of group B only had non-operative treatment, mainly including oral nonsteroidal anti-inflammatory drugs (NSAIDs) and rehabilitative treatment. Visual analog scale (VAS) scores, knee society knee scores (KSS), range of motion (knee flexion and knee extension) were obtained before treatment and at 1 month, 3 months, and 6 months after treatment. Radiography of after-treatment was also evaluated to assess the changes in HO. There were 3 males and 27 females with a mean age of 67.4 ± 0.8 years in group A and 68.2 ± 1.3 in group B. The onset time of HO was 3–6 months. The maximum size of the ossification was < 2 cm in 23 knees, 2 cm < heterotopic bone < 5 cm in 6 knees and > 5 cm in 1 knee. The size of HO decreased gradually in all knees by X-ray film at the last follow-up. There were no significant differences in VAS scores after replacement between two groups (p > 0.05). The average range of motion preoperatively in group A was − 15.2–90.6°, which postoperatively increased to − 4.2–110.0°. Meanwhile, the KSS scores and average range of motion of the group A were better than those of the group B at each follow-up time after treatment. Arthroscopic debridement can decrease HO seen from postoperative X-rays, improve the function and range of motion, as well as the pain remission between two groups are comparable. Consequently, arthroscopic resection of HO after TKR is recommended as soon as there is aggravating joint stiffness. |
| first_indexed | 2024-04-24T23:08:02Z |
| format | Article |
| id | doaj.art-4d6ebc5c496d40e99b7a85b2a106ea0b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T23:08:02Z |
| publishDate | 2024-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-4d6ebc5c496d40e99b7a85b2a106ea0b2024-03-17T12:22:30ZengNature PortfolioScientific Reports2045-23222024-03-0114111110.1038/s41598-024-56300-1Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort studyDong-Liang Zhang0Wei Zhang1Yi-Ming Ren2Wen-Jun Zhao3He-Jun Sun4Zheng-Wei Tian5Meng-Qiang Tian6Department of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalNursing Department, Tianjin Union Medical Center, Nankai University Affiliated People’s HospitalDepartment of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalDepartment of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalDepartment of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalDepartment of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalDepartment of Joint and Sport Medicine, Tianjin Union Medical Center, Tianjin Medical University, Nankai University Affiliated People’s HospitalAbstract The presence of heterotopic ossification (HO) after primary total knee replacement (TKR) is rare and associated with limited mobility and stiffness of the knee. This study aimed to identify if the arthroscopic debridement after TKR could decrease HO and improve the function and range of motion. Thirty HO patients after TKR were retrospectively separated into 2 cohorts. 15 patients of group A accepted the arthroscopic debridement, while 15 patients of group B only had non-operative treatment, mainly including oral nonsteroidal anti-inflammatory drugs (NSAIDs) and rehabilitative treatment. Visual analog scale (VAS) scores, knee society knee scores (KSS), range of motion (knee flexion and knee extension) were obtained before treatment and at 1 month, 3 months, and 6 months after treatment. Radiography of after-treatment was also evaluated to assess the changes in HO. There were 3 males and 27 females with a mean age of 67.4 ± 0.8 years in group A and 68.2 ± 1.3 in group B. The onset time of HO was 3–6 months. The maximum size of the ossification was < 2 cm in 23 knees, 2 cm < heterotopic bone < 5 cm in 6 knees and > 5 cm in 1 knee. The size of HO decreased gradually in all knees by X-ray film at the last follow-up. There were no significant differences in VAS scores after replacement between two groups (p > 0.05). The average range of motion preoperatively in group A was − 15.2–90.6°, which postoperatively increased to − 4.2–110.0°. Meanwhile, the KSS scores and average range of motion of the group A were better than those of the group B at each follow-up time after treatment. Arthroscopic debridement can decrease HO seen from postoperative X-rays, improve the function and range of motion, as well as the pain remission between two groups are comparable. Consequently, arthroscopic resection of HO after TKR is recommended as soon as there is aggravating joint stiffness.https://doi.org/10.1038/s41598-024-56300-1Total knee replacementHeterotopic ossificationArthroscopyRange of motionRevision |
| spellingShingle | Dong-Liang Zhang Wei Zhang Yi-Ming Ren Wen-Jun Zhao He-Jun Sun Zheng-Wei Tian Meng-Qiang Tian Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study Scientific Reports Total knee replacement Heterotopic ossification Arthroscopy Range of motion Revision |
| title | Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study |
| title_full | Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study |
| title_fullStr | Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study |
| title_full_unstemmed | Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study |
| title_short | Arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement: a retrospective cohort study |
| title_sort | arthroscopic debridement improves range of motion for heterotopic ossification after total knee replacement a retrospective cohort study |
| topic | Total knee replacement Heterotopic ossification Arthroscopy Range of motion Revision |
| url | https://doi.org/10.1038/s41598-024-56300-1 |
| work_keys_str_mv | AT dongliangzhang arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT weizhang arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT yimingren arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT wenjunzhao arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT hejunsun arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT zhengweitian arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy AT mengqiangtian arthroscopicdebridementimprovesrangeofmotionforheterotopicossificationaftertotalkneereplacementaretrospectivecohortstudy |