Arthroscopic treatment of total knee arthroplasty complications

Abstract

The most frequent indications for arthroscopy in patients with total knee arthroplasty (TKA) are soft-tissue impingement, arthrofibrosis (knee stiffness), periprosthetic infection and removal of free bodies or cement fragments. When performing a knee arthroscopy in a patient with a symptomatic TKA, look for possible free/retained bone or cement fragments, which can be anywhere in the joint. Patellar tracking should be evaluated and soft-tissue impingement under the patella or between the femoral and tibial prosthetic components should be ruled out. Current data suggest that knee arthroscopy is an effective procedure for the treatment of some patients with symptomatic TKA. The approximate rates of therapeutic success vary according to the problem in question: 85% in soft-tissue impingement; 90% in arthrofibrosis; and 55% in periprosthetic infections. More clinical studies are needed to determine which patients with symptomatic TKA can be the best candidates for knee arthroscopy.