Lymphedema Microsurgery Reduces the Rate of Implant Removal for Patients Who Have Pre-existing Lymphedema and Total Knee Arthroplasty for Knee Osteoarthritis

• Main Author: Tsz Yin Voravitvet
• Other Authors: F. C. Wei
• Format: Others
• Language: en_US
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi/login?o=dnclcdr&s=id=%22107CGU05416008%22.&searchmode=basic

碩士 === 長庚大學 === 顯微手術國際碩士學位學程 === 107 === Introduction: Patients with pre-existing lymphedema who undergo total knee arthroplasty for osteoarthritis are at a high risk of periprosthetic joint infection. This complication usually requires removal of the implant. This study aims to investigate whether surgical treatment of lymphedema reduced the rate of implant/prosthesis removal in such patients. Materials and methods: We retrospectively reviewed our prospective database of patient information collected between January 2009 to December 2018. A total of 348 cases of lower extremity lymphedema were reviewed and those who underwent total knee arthroplasty (TKA) for osteoarthritis (OA) of the knee were included. Patient demographics, clinical data, lymphedema surgical history, and TKA surgical history including any episodes of removal were collected and analyzed. Results: There were 9 lymphedema patients with knee OA who subsequently underwent TKA. The mean patient age was 70.4 ± 7.1 years. A total of 18 TKAs were performed in 9 patients. The knee prosthesis removal rate was 66.7% (12/18). The prosthesis removal rate was 40% (2/5) in patients who underwent lymphedema microsurgery versus 76.9% (10/13) for those who did not (p = 0.03). Conclusions: Pre-existing lymphedema is associated with a high rate of knee prosthesis removal. Lymphedema microsurgery reduced the removal rate of knee prostheses. We recommend that surgical lymphedema treatment is considered for patients who require TKA as treatment for osteoarthritis of the knee.