What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?

Kengo Harato, Hidenori Tanikawa, Yutaro Morishige, Kazuya Kaneda, Yasuo Niki

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Wound condition after primary total knee arthroplasty (TKA) is an important issue to oid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. Methods: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m2), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. Results: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. Conclusions: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.

Original languageEnglish
Article number7
JournalJournal of Orthopaedic Surgery and Research
Volume11
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Knee Replacement Arthroplasties
Wound Healing
Tibia
Patella
Wounds and Injuries
Knee
Femur
Sutures
Wound Closure Techniques
Tourniquets
Skin
Operative Time
Comorbidity
Drainage
Body Mass Index
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

What are the important surgical factors affecting the wound healing after primary total knee arthroplasty? / Harato, Kengo; Tanikawa, Hidenori; Morishige, Yutaro; Kaneda, Kazuya; Niki, Yasuo.

In: Journal of Orthopaedic Surgery and Research, Vol. 11, No. 1, 7, 2016.

Research output: Contribution to journalArticle

@article{16b39593fd3c49dcb34e127685e5c31e,
title = "What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?",
abstract = "Background: Wound condition after primary total knee arthroplasty (TKA) is an important issue to oid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. Methods: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m2), HbA1C ({\%}), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. Results: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. Conclusions: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.",
author = "Kengo Harato and Hidenori Tanikawa and Yutaro Morishige and Kazuya Kaneda and Yasuo Niki",
year = "2016",
doi = "10.1186/s13018-016-0340-y",
language = "English",
volume = "11",
journal = "Journal of Orthopaedic Surgery and Research",
issn = "1749-799X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - What are the important surgical factors affecting the wound healing after primary total knee arthroplasty?

AU - Harato, Kengo

AU - Tanikawa, Hidenori

AU - Morishige, Yutaro

AU - Kaneda, Kazuya

AU - Niki, Yasuo

PY - 2016

Y1 - 2016

N2 - Background: Wound condition after primary total knee arthroplasty (TKA) is an important issue to oid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. Methods: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m2), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. Results: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. Conclusions: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.

AB - Background: Wound condition after primary total knee arthroplasty (TKA) is an important issue to oid any postoperative adverse events. Our purpose was to investigate and to clarify the important surgical factors affecting wound score after TKA. Methods: A total of 139 knees in 128 patients (mean 73 years) without severe comorbidity were enrolled in the present study. All primary unilateral or bilateral TKAs were done using the same skin incision line, measured resection technique, and wound closure technique using unidirectional barbed suture. In terms of the wound healing, Hollander Wound Evaluation Score (HWES) was assessed on postoperative day 14. We performed multiple regression analysis using stepwise method to identify the factors affecting HWES. Variables considered in the analysis were age, sex, body mass index (kg/m2), HbA1C (%), femorotibial angle (degrees) on plain radiographs, intraoperative patella eversion during the cutting phase of the femur and the tibia in knee flexion, intraoperative anterior translation of the tibia, patella resurfacing, surgical time (min), tourniquet time (min), length of skin incision (cm), postoperative drainage (ml), patellar height on postoperative lateral radiographs, and HWES. HWES was treated as a dependent variable, and others were as independent variables. Results: The average HWES was 5.0 ± 0.8 point. According to stepwise forward regression test, patella eversion during the cutting phase of the femur and the tibia in knee flexion and anterior translation of the tibia were entered in this model, while other factors were not entered. Standardized partial regression coefficient was as follows: 0.57 in anterior translation of the tibia and 0.38 in patella eversion. Conclusions: Fortunately, in the present study using the unidirectional barbed suture, major wound healing problem did not occur. As to the surgical technique, intraoperative patella eversion and anterior translation of the tibia should be avoided for quality cosmesis in primary TKA.

UR - http://www.scopus.com/inward/record.url?scp=84990062606&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990062606&partnerID=8YFLogxK

U2 - 10.1186/s13018-016-0340-y

DO - 10.1186/s13018-016-0340-y

M3 - Article

C2 - 26762213

AN - SCOPUS:84954096919

VL - 11

JO - Journal of Orthopaedic Surgery and Research

JF - Journal of Orthopaedic Surgery and Research

SN - 1749-799X

IS - 1

M1 - 7

ER -