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Causes of knee pain evaluated by arthroscopy after knee arthroplasty: a case series

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Abstract

Background

The origin of persistent pain and joint limitation after knee arthroplasty are controversial and difficult to diagnose. Knee arthroscopy is indicated when the results of routine evaluation tests are not clear. The purpose of this study was to determine through arthroscopy the cause of post-knee-arthroplasty pain symptoms in patients without a prior diagnosis of cause of pain.

Methods

This prospective case series study described the outcomes of 34 patients (35 knees) with pain and limited function in the arthroplastic joint, who underwent diagnostic and therapeutic arthroscopy. Patients were clinically evaluated using range-of-motion tests and the Lysholm, Hospital for Special Surgery (HSS) and Knee Society Score (KSS) scales.

Results

The procedure found cyclops in 17 knees, synovitis in 9 knees, arthrofibrosis in 6 knees, polyethylene wear with debris in two knees, and polyethylene bouncing in one knee with unicompartmental arthroplasty with a mobile polyethylene platform. It was effective for the relief of pain symptoms, with excellent or good outcomes in 80% of cases; there was a poor outcome in 11.43%, which maintained the presentation of pain and underwent revision arthroplasty, and, in 8.57%, did not undergo another surgery despite symptom persistence.

Conclusions

Post-arthroplasty knee arthroscopy seems beneficial in patients with pain and without a pre-established diagnosis and who had already undergone conservative treatment unsuccessfully.

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Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Santa Casa Medical School and Hospitals, R. Dr. Cesário Motta Junior, 112, São Paulo, 01221-020, Brazil

    Fabricio Roberto Severino, Victor Marques de Oliveira, Ricardo de Paula Leite Cury, Nilson Roberto Severino & Patricia Maria de Moraes Barros Fucs

Authors
  1. Fabricio Roberto Severino
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  2. Victor Marques de Oliveira
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  3. Ricardo de Paula Leite Cury
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  4. Nilson Roberto Severino
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  5. Patricia Maria de Moraes Barros Fucs
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Contributions

Fabricio Roberto Severino MD assistant surgeon, work on all phases of the project.

Victor Marques de Oliveira MD assistant surgeon, clinical evaluation.

Ricardo de Paula Leite Cury MD assistant surgeon, clinical evaluation.

Nilson Roberto Severino MD, PhD create the project, responsible surgeon for the patients, work on all phases of the project.

Patricia Maria de Moraes Barros Fucs MD, PhD elaboration of the project, written and correction of the text, work on all phases of the project.

Corresponding author

Correspondence to Patricia Maria de Moraes Barros Fucs.

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Ethical approval

Study approved by the Ethical Board CEP-ISCMSC CAAE 20,287,013.0.0000.5479.

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The authors declare no conflict of interest.

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Severino, F.R., de Oliveira, V.M., de Paula Leite Cury, R. et al. Causes of knee pain evaluated by arthroscopy after knee arthroplasty: a case series. International Orthopaedics (SICOT) 46, 697–703 (2022). https://doi.org/10.1007/s00264-021-05048-8

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  • DOI: https://doi.org/10.1007/s00264-021-05048-8

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