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Medicina
Special Issues
Knee Replacement: Complications and Associated Diseases
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Knee Replacement: Complications and Associated Diseases

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 8371

Special Issue Editors

Dr. Vincenzo Candela

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Guest Editor
Orthopaedics and Traumatology Specialist, Campus Bio-Medico University Hospital, Rome, Italy
Interests: knee and hip prosthetic surgery; sports traumatology
Prof. Dr. Rocco Papalia

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Guest Editor
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, 00128 Rome, Italy
Interests: osteoarthritis; knee surgery; hip surgery; total hip reconstruction; regenerative medicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Umile Giuseppe Longo

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Guest Editor
Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy
Interests: artroscopy; shoulder; knee; ankle; joint
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Knee replacement (KR) is one of the most clinically successful and cost-effective medical procedures developed during the last 50 years. KR is widely considered a safe and effective procedure for patients with end-stage osteoarthritis or inflammatory arthritis of the knee. Nevertheless, complications during and after KR may occur. Complications related to KR, although uncommon, range from minor problems to devastating life-threatening events. A complication can be defined as a morbid process or event occurring during a disease which is not an essential part of the disease, although it may result from it or from independent causes.  The purpose of this Special Issue is to analyze complications after KR and diseases associated with KR. Systemic complications after KR include myocardial infarction, pulmonary embolism, shock, cerebrovascular accident, renal failure, urinary retention, organ infection, and deep vein thrombosis (DVT). Although not always possible, the prevention of these complications is of utmost importance as they can have fatal impacts. The orthopedic surgeons are required to diagnose and prevent these complications during the early postoperative period. Knee joint complications include pain, swelling, motion limitation, instability and dislocation of the prosthesis, vascular complications, nerve palsy, component breakage, complications of the extensor mechanism, hematomas, wound drainages, superficial infections, skin necrosis, deep infection, aseptic loosening, osteolysis, and periprosthetic fractures. We invite authors to submit articles related to these topics.

Papers submitted to this Special Issue may cover all aspects related to complications and associated diseases after knee arthroplasty.

Dr. Vincenzo Candela
Prof. Dr. Rocco Papalia 
Prof. Dr. Umile Giuseppe Longo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • knee replacement
  • complications
  • arthroplasty
  • infection

Published Papers (2 papers)

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Research

12 pages, 1118 KiB  
Article
Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty
by Răzvan Marian Melinte, Emil Marian Arbănași, Adrian Blesneac, Dan Nicolae Zolog, Réka Kaller, Adrian Vasile Mureșan, Eliza Mihaela Arbănași, Ioana Marta Melinte, Raluca Niculescu and Eliza Russu
Medicina 2022, 58(10), 1502; https://doi.org/10.3390/medicina58101502 - 21 Oct 2022
Cited by 23 | Viewed by 2513
Abstract
Background and objectives: Deep vein thrombosis (DVT) is one of the most serious post-operative complications in the case of total knee arthroplasty (TKA). This study aims to verify the predictive role of inflammatory biomarkers [monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio [...] Read more.
Background and objectives: Deep vein thrombosis (DVT) is one of the most serious post-operative complications in the case of total knee arthroplasty (TKA). This study aims to verify the predictive role of inflammatory biomarkers [monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)] in acute DVT following TKA. Materials and methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with surgical indications for TKA, admitted to the Department of Orthopedics, Regina Maria Health Network, Targu Mures, Romania, and the Department of Orthopedics, Humanitas MedLife Hospital, Cluj-Napoca, Romania between January 2017 and July 2022. The primary endpoint was the risk of acute DVT following the TKA, and the secondary endpoint was the length of hospital stay, and the outcomes were stratified for the baseline’s optimal MLR, NLR, PLR, SII, SIRI, and AISI cut-off value. Results: DVT patients were associated with higher age (p = 0.01), higher incidence of cardiac disease [arterial hypertension (p = 0.02), atrial fibrillation (p = 0.01)], malignancy (p = 0.005), as well as risk factors [smoking (p = 0.03) and obesity (p = 0.02)]. Multivariate analysis showed a high baseline value for all hematological ratios: MLR (OR: 11.06; p < 0.001), NLR (OR: 10.15; p < 0.001), PLR (OR: 12.31; p < 0.001), SII (OR: 18.87; p < 0.001), SIRI (OR: 10.86; p < 0.001), and AISI (OR: 14.05; p < 0.001) was an independent predictor of DVT after TKA for all recruited patients. Moreover, age above 70 (OR: 2.96; p = 0.007), AH (OR: 2.93; p = 0.02), AF (OR: 2.71; p = 0.01), malignancy (OR: 3.98; p = 0.002), obesity (OR: 2.34; p = 0.04), and tobacco (OR: 2.30; p = 0.04) were all independent predictors of DVT risk. Conclusions: Higher pre-operative hematological ratios MLR, NLR, PLR, SII, SIRI, and AISI values determined before operations strongly predict acute DVT following TKA. Moreover, age over 70, malignancy, cardiovascular disease, and risk factors such as obesity and tobacco were predictive risk factors for acute DVT. Full article
(This article belongs to the Special Issue Knee Replacement: Complications and Associated Diseases)
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9 pages, 2966 KiB  
Article
Is the Numbness after Knee Replacement a More Critical Complication Than Thought? A Detailed Analysis of Neuropathic Pain and Functional Outcomes
by Deniz Gurler and Ismail Buyukceran
Medicina 2022, 58(10), 1369; https://doi.org/10.3390/medicina58101369 - 29 Sep 2022
Viewed by 5371
Abstract
Background and Objectives: Numbness, one of the complications after knee replacement (KR), has been studied far less than other complications, and there are few studies on this topic. Without comprehensive research on numbness, there is a need to design a study that [...] Read more.
Background and Objectives: Numbness, one of the complications after knee replacement (KR), has been studied far less than other complications, and there are few studies on this topic. Without comprehensive research on numbness, there is a need to design a study that includes all relevant parameters. This study investigated the relationship between numbness and pain and neuropathic pain and its impact on functional and emotional life and the functioning of the knee. Materials and Methods: The 105 knees with KRs were divided anteriorly into six regions. Numbness was determined with a pinprick test. Douleur Neuropathique 4 (DN4) and a painDETECT questionnaire (PD-Q) were tested for neuropathic pain. Patients’ physical, emotional, and social status and functional knee abilities were assessed with the Short Form (SF-36) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) test. The relationships between numbness and gender, age, bilaterality, postoperative follow-up time, and incision measures were examined. The binomial logistic regression model was applied to investigate the effects of age, gender, bilaterality, incision length, and postoperative follow-up time on numbness. Results: A total of 88.6% of the patients were female, half had bilateral KRs, and the mean age was 68.3 years. Numbness occurred more frequently in the L3 and L2 areas than in other regions. There was no association with gender, bilaterality, and age, but there was a weak association with postoperative follow-up time. There was a positive correlation between numbness and neuropathic pain. It has been found that there is a significant relationship between numbness and physical function, and it has a negative effect. Emotional health was not significantly associated with numbness. The effect of numbness on social functioning was statistically significant. Knee functioning was measured with the WOMAC, and significant differences were found in the numbness group. Conclusions: According to the results, numbness is considered to be a complication that affects social and physical life and has a negative impact on functional outcomes of the knee. The results show that it should be considered a statistically significant complication. Numbness and its indirect effects should be considered in patients whose follow-up parameters are normal over one year but whose symptoms do not resolve. Full article
(This article belongs to the Special Issue Knee Replacement: Complications and Associated Diseases)
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