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Fibrosis is a common outcome following total knee arthroplasty

Lookup NU author(s): Dr Nicole Abdul, David Dixon, Andrew Walker, Joanna Horabin, Professor David Deehan, Professor Derek Mann, Dr Lee Borthwick

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Total knee arthroplasty (TKA) is one of the most successful orthopaedic procedures that alleviates pain and restores function in patients with degenerative knee joint diseases. Arthrofibrosis, abnormal scarring in which dense fibrous tissue prevents normal range of motion, develops in similar to 3-10% of TKA patients. No prophylactic intervention is available and treatment is restricted to aggressive physiotherapy or revision surgery. Tissue was collected from patients undergoing primary (n = 30) or revision (n = 27) TKA. Revision patients were stratified as non-arthrofibrotic and arthrofibrotic. Tissue was macroscopically and histologically compared to improve our understanding of the pathophysiology of arthrofibrosis. Macroscopically, tissue from primary TKA presents as homogenous, fatty tissue whereas tissue from revision TKA presents as dense, pigmented tissue. Histologically, there was dramatic tissue remodelling, increased collagen deposition and increased (myo) fibroblast staining in tissue from revision TKA. Significantly, tissue architecture was similar between revision patients regardless of clinically diagnosis. There are significant differences in architecture and composition of tissue from revision TKA over primary TKA. Surprisingly, whether revision TKA were clinically diagnosed as arthrofibrotic or non-arthrofibrotic there were still significant differences in fibrotic markers compared to primary TKA suggesting an ongoing fibrotic process in all revision knees.


Publication metadata

Author(s): Abdul N, Dixon D, Walker A, Horabin J, Smith N, Weir DJ, Brewster NT, Deehan DJ, Mann DA, Borthwick LA

Publication type: Article

Publication status: Published

Journal: Scientific Reports

Year: 2015

Volume: 5

Online publication date: 10/11/2015

Acceptance date: 12/10/2015

Date deposited: 01/03/2016

ISSN (electronic): 2045-2322

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/srep16469

DOI: 10.1038/srep16469

PubMed id: 26553967


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