Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2020

24.09.2019 | KNEE

There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis

verfasst von: Jore H. Willems, Rachid Rassir, Inger N. Sierevelt, Peter A. Nolte

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Chondrocalcinosis is the radiographic appearance of calcium crystals in cartilage and other soft tissue. It is suggested that preoperative chondrocalcinosis predicts a worse outcome after total knee arthroplasty and it is unclear if chondrocalcinosis leads to more postoperative complications. This study aimed to compare function, pain, postoperative complications, postoperative signs of acute arthritis and revision rates between patients with and without chondrocalcinosis undergoing total knee arthroplasty for osteoarthritis.

Methods

In this retrospective cohort study performed in 2017, 408 knees in 392 patients (16 bilateral total knee arthroplasties) were included. None of the patients received additional synovectomy. PROMs were evaluated after 1 year (n = 294) and 5 years (n = 308). The follow-up for clinical data was 5 years (n = 408). The range of final follow-up was 57–84 months. All preoperative radiographs were scored for chondrocalcinosis and Oxford Knee Score, Knee Society Score and Algofunctional Index were used to assess outcome. All clinical records were screened for postoperative complications (excessive wound discharge, infection, loosening, PAO, stiffness), arthritis after surgery and reoperation or revision for any reason.

Results

Sixty-three knees (15.4%) showed signs of chondrocalcinosis. Male gender, higher age and lower BMI were risk factors for chondrocalcinosis. No difference was found in Oxford Knee Score, Knee Society Score and Algofunctional Index, nor in postoperative complications, postoperative signs of acute arthritis and revision rate.

Conclusion

Patients with and without chondrocalcinosis have the same outcome after total knee arthroplasty related to pain, functionality, complications, arthritis and revision after surgery for end-stage osteoarthritis. Chondrocalcinosis is not a contraindication for total knee arthroplasty and additional synovectomy is unnecessary.

Level of evidence

III.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Abu-Amer Y, Darwech I, Clohisy JC (2007) Aseptic loosening of total joint replacements: mechanisms underlying osteolysis and potential therapies. Arthritis Res Ther 9(Suppl 1):S6PubMedPubMedCentral Abu-Amer Y, Darwech I, Clohisy JC (2007) Aseptic loosening of total joint replacements: mechanisms underlying osteolysis and potential therapies. Arthritis Res Ther 9(Suppl 1):S6PubMedPubMedCentral
2.
Zurück zum Zitat Canhao H, Fonseca JE, Leandro MJ, Romeu JC, Pimentao JB, Costa JT et al (2001) Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy. Clin Rheumatol 20:119–122PubMed Canhao H, Fonseca JE, Leandro MJ, Romeu JC, Pimentao JB, Costa JT et al (2001) Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy. Clin Rheumatol 20:119–122PubMed
3.
Zurück zum Zitat Cheung HS, Kurup IV, Sallis JD, Ryan LM (1996) Inhibition of calcium pyrophosphate dihydrate crystal formation in articular cartilage vesicles and cartilage by phosphocitrate. J Biol Chem 271:28082–28085PubMed Cheung HS, Kurup IV, Sallis JD, Ryan LM (1996) Inhibition of calcium pyrophosphate dihydrate crystal formation in articular cartilage vesicles and cartilage by phosphocitrate. J Biol Chem 271:28082–28085PubMed
4.
Zurück zum Zitat Clement ND, MacDonald D, Simpson AH, Lee WC, Kwan YH, Chong HC et al (2014) The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22:1933–1939PubMed Clement ND, MacDonald D, Simpson AH, Lee WC, Kwan YH, Chong HC et al (2014) The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22:1933–1939PubMed
5.
Zurück zum Zitat Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Jt Surg Br 80:63–69 Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Jt Surg Br 80:63–69
6.
Zurück zum Zitat Derfus BA, Kurian JB, Butler JJ, Daft LJ, Carrera GF, Ryan LM et al (2002) The high prevalence of pathologic calcium crystals in pre-operative knees. J Rheumatol 29:570–574PubMed Derfus BA, Kurian JB, Butler JJ, Daft LJ, Carrera GF, Ryan LM et al (2002) The high prevalence of pathologic calcium crystals in pre-operative knees. J Rheumatol 29:570–574PubMed
7.
Zurück zum Zitat Doherty M, Dieppe P (1986) Crystal deposition disease in the elderly. Clin Rheum Dis 12:97–116PubMed Doherty M, Dieppe P (1986) Crystal deposition disease in the elderly. Clin Rheum Dis 12:97–116PubMed
8.
Zurück zum Zitat Ea H-K, Lioté F (2014) Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am 40:207–229PubMed Ea H-K, Lioté F (2014) Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am 40:207–229PubMed
9.
Zurück zum Zitat Fam AG, Morava-Protzner I, Purcell C, Young BD, Bunting PS, Lewis AJ (1995) Acceleration of experimental lapine osteoarthritis by calcium pyrophosphate microcrystalline synovitis. Arthritis Rheum 38:201–210PubMed Fam AG, Morava-Protzner I, Purcell C, Young BD, Bunting PS, Lewis AJ (1995) Acceleration of experimental lapine osteoarthritis by calcium pyrophosphate microcrystalline synovitis. Arthritis Rheum 38:201–210PubMed
10.
Zurück zum Zitat Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF (1989) The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol 16:1241–1245PubMed Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF (1989) The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol 16:1241–1245PubMed
11.
Zurück zum Zitat Fuerst M, Bertrand J, Lammers L, Dreier R, Echtermeyer F, Nitschke Y et al (2009) Calcification of articular cartilage in human osteoarthritis. Arthritis Rheum 60:2694–2703PubMed Fuerst M, Bertrand J, Lammers L, Dreier R, Echtermeyer F, Nitschke Y et al (2009) Calcification of articular cartilage in human osteoarthritis. Arthritis Rheum 60:2694–2703PubMed
12.
Zurück zum Zitat George MP, Ernste FC, Tande A, Osmon D, Mabry T, Berbari EF (2019) Clinical presentation, management and prognosis of pseudogout in joint arthrplasty: a retrospective cohort study. J Bone Jt Infect 4(1):20–26PubMedPubMedCentral George MP, Ernste FC, Tande A, Osmon D, Mabry T, Berbari EF (2019) Clinical presentation, management and prognosis of pseudogout in joint arthrplasty: a retrospective cohort study. J Bone Jt Infect 4(1):20–26PubMedPubMedCentral
13.
Zurück zum Zitat Hawellek T, Hubert J, Hischke S, Krause M, Bertrand J, Pap T, Puschel K, Ruther W, Niemeier A (2016) Articular cartilage calcification of the hip and knee is highly prevalent, independent of age but associated with histological osteoarthritis: evidence for a systemic disorder. Osteoarthritis Cartilage 24(12):2092–2099PubMed Hawellek T, Hubert J, Hischke S, Krause M, Bertrand J, Pap T, Puschel K, Ruther W, Niemeier A (2016) Articular cartilage calcification of the hip and knee is highly prevalent, independent of age but associated with histological osteoarthritis: evidence for a systemic disorder. Osteoarthritis Cartilage 24(12):2092–2099PubMed
14.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
15.
Zurück zum Zitat Ishikawa K, Masuda I, Ohira T, Yokoyama M (1989) A histological study of calcium pyrophosphate dihydrate crystal-deposition disease. J Bone Jt Surg Am 71:875–886 Ishikawa K, Masuda I, Ohira T, Yokoyama M (1989) A histological study of calcium pyrophosphate dihydrate crystal-deposition disease. J Bone Jt Surg Am 71:875–886
16.
Zurück zum Zitat Iwasaki K, Nakamura T, Shin S, Nakagawa T, Itouda K, Tsuchiya K (2019) Calcium pyrophosphate deposition disease after total knee arthroplasty: comparison with periprosthetic joint infection. J Orthop 16(2):128–132PubMedPubMedCentral Iwasaki K, Nakamura T, Shin S, Nakagawa T, Itouda K, Tsuchiya K (2019) Calcium pyrophosphate deposition disease after total knee arthroplasty: comparison with periprosthetic joint infection. J Orthop 16(2):128–132PubMedPubMedCentral
17.
19.
Zurück zum Zitat Kumar V, Pandit HG, Liddle AD, Borror W, Jenkins C, Mellow SJ, Hamilton TW, Athanasou N, Dodd CA, Murray DW (2017) Comparison of outcomes after UKA in patients with and without chondrocalcinosis: a matched cohort study. Knee Surg Sports Traumatol Arthrosc 25(1):319–324PubMed Kumar V, Pandit HG, Liddle AD, Borror W, Jenkins C, Mellow SJ, Hamilton TW, Athanasou N, Dodd CA, Murray DW (2017) Comparison of outcomes after UKA in patients with and without chondrocalcinosis: a matched cohort study. Knee Surg Sports Traumatol Arthrosc 25(1):319–324PubMed
20.
Zurück zum Zitat Lee GC, Lotke PA (2014) Does chondrocalcinosis affect Knee Society scores and range of motion after TKA? Clin Orthop Relat Res 472:1512–1517PubMedPubMedCentral Lee GC, Lotke PA (2014) Does chondrocalcinosis affect Knee Society scores and range of motion after TKA? Clin Orthop Relat Res 472:1512–1517PubMedPubMedCentral
21.
Zurück zum Zitat Lequesne MG (1997) The algofunctional indices for hip and knee osteoarthritis. J Rheumatol 24:779–781PubMed Lequesne MG (1997) The algofunctional indices for hip and knee osteoarthritis. J Rheumatol 24:779–781PubMed
22.
Zurück zum Zitat Levi GS, Sadr K, Scuderi GR (2012) Bilateral pseudogout 8 years after bilateral total knee arthroplasty. Orthop Clin North Am 43:e59–e62PubMed Levi GS, Sadr K, Scuderi GR (2012) Bilateral pseudogout 8 years after bilateral total knee arthroplasty. Orthop Clin North Am 43:e59–e62PubMed
23.
Zurück zum Zitat Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB (2001) Validity and responsiveness of the knee society clinical rating system in comparison with the SF-36 and WOMAC. J Bone Jt Surg Am 83(12):1856–1864 Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB (2001) Validity and responsiveness of the knee society clinical rating system in comparison with the SF-36 and WOMAC. J Bone Jt Surg Am 83(12):1856–1864
24.
Zurück zum Zitat Liote F, Ea HK (2014) Clinical implications of pathogenic calcium crystals. Curr Opin Rheumatol 26(2):192–196PubMed Liote F, Ea HK (2014) Clinical implications of pathogenic calcium crystals. Curr Opin Rheumatol 26(2):192–196PubMed
25.
Zurück zum Zitat Louthrenoo W, Sukitawut W (1999) Calcium pyrophosphate dihydrate crystal deposition: a clinical and laboratory analysis of 91 Thai patients. J Med Assoc Thai 82:569–576PubMed Louthrenoo W, Sukitawut W (1999) Calcium pyrophosphate dihydrate crystal deposition: a clinical and laboratory analysis of 91 Thai patients. J Med Assoc Thai 82:569–576PubMed
26.
Zurück zum Zitat Masuda I, Ishikawa K, Usuku G (1991) A histologic and immunohistochemical study of calcium pyrophosphate dihydrate crystal deposition disease. Clin Orthop Relat Res 263:272–287 Masuda I, Ishikawa K, Usuku G (1991) A histologic and immunohistochemical study of calcium pyrophosphate dihydrate crystal deposition disease. Clin Orthop Relat Res 263:272–287
27.
Zurück zum Zitat Muehleman C, Li J, Aigner T, Rappoport L, Mattson E, Hirschmugl C et al (2008) Association between crystals and cartilage degeneration in the ankle. J Rheumatol 35:1108–1117PubMedPubMedCentral Muehleman C, Li J, Aigner T, Rappoport L, Mattson E, Hirschmugl C et al (2008) Association between crystals and cartilage degeneration in the ankle. J Rheumatol 35:1108–1117PubMedPubMedCentral
28.
Zurück zum Zitat Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ et al (2007) The use of the Oxford hip and knee scores. J Bone Jt Surg Br 89:1010–1014 Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ et al (2007) The use of the Oxford hip and knee scores. J Bone Jt Surg Br 89:1010–1014
29.
Zurück zum Zitat Nalbant S, Martinez JA, Kitumnuaypong T, Clayburne G, Sieck M, Schumacher HR Jr (2003) Synovial fluid features and their relations to osteoarthritis severity: new findings from sequential studies. Osteoarthritis Cartilage 11:50–54PubMed Nalbant S, Martinez JA, Kitumnuaypong T, Clayburne G, Sieck M, Schumacher HR Jr (2003) Synovial fluid features and their relations to osteoarthritis severity: new findings from sequential studies. Osteoarthritis Cartilage 11:50–54PubMed
30.
Zurück zum Zitat Neame RL, Carr AJ, Muir K, Doherty M (2003) UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis 62:513–518PubMedPubMedCentral Neame RL, Carr AJ, Muir K, Doherty M (2003) UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis 62:513–518PubMedPubMedCentral
31.
Zurück zum Zitat Resnick D, Niwayama G, Goergen TG, Utsinger PD, Shapiro RF, Haselwood DH et al (1977) Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD): pseudogout. Radiology 122:1–15PubMed Resnick D, Niwayama G, Goergen TG, Utsinger PD, Shapiro RF, Haselwood DH et al (1977) Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD): pseudogout. Radiology 122:1–15PubMed
33.
Zurück zum Zitat Ryan L, McCarty D, Koopman W (1997) Calcium pyrophosphate crystal deposition disease, pseudogout, and articular chondrocalcinosis. Williams and Wilkins, Baltimore, pp 2103–2125 Ryan L, McCarty D, Koopman W (1997) Calcium pyrophosphate crystal deposition disease, pseudogout, and articular chondrocalcinosis. Williams and Wilkins, Baltimore, pp 2103–2125
34.
Zurück zum Zitat Sanchis Martinez A, Pascual E (2005) Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy. Ann Rheum Dis 64:1769–1772 Sanchis Martinez A, Pascual E (2005) Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy. Ann Rheum Dis 64:1769–1772
35.
Zurück zum Zitat Sato R, Nakato S, Takasago T, Nakamura M, Kashima M, Chikawa T, Hamada D, Goto T, Sairyo K (2015) Chondrogenesis in the synovial tissue is associated with the onset of pseudogout after total knee arthroplasty. Arthroplast Today 11(3):101–104 Sato R, Nakato S, Takasago T, Nakamura M, Kashima M, Chikawa T, Hamada D, Goto T, Sairyo K (2015) Chondrogenesis in the synovial tissue is associated with the onset of pseudogout after total knee arthroplasty. Arthroplast Today 11(3):101–104
36.
Zurück zum Zitat Soloway S, Tucker BS (2016) Calcium pyrophosphate dihydrate deposition disease in a knee with total joint replacement. J Clin Rheumatol 22(5):277PubMed Soloway S, Tucker BS (2016) Calcium pyrophosphate dihydrate deposition disease in a knee with total joint replacement. J Clin Rheumatol 22(5):277PubMed
37.
Zurück zum Zitat Utsinger PD, Resnick D, Zvaifler NJ (1975) Wrist arthropathy in calcium pyrophosphate dihydrate deposition disease. Arthritis Rheum 18:485–491PubMed Utsinger PD, Resnick D, Zvaifler NJ (1975) Wrist arthropathy in calcium pyrophosphate dihydrate deposition disease. Arthritis Rheum 18:485–491PubMed
38.
Zurück zum Zitat Yahia SA, Zeller V, Desplaces N, Chazerain P, Lhotellier L, Marmor S, Ziza JM (2016) Crystal induced arthritis after arthroplasty: 7 cases. Jt Bone Spine 83(5):559–562 Yahia SA, Zeller V, Desplaces N, Chazerain P, Lhotellier L, Marmor S, Ziza JM (2016) Crystal induced arthritis after arthroplasty: 7 cases. Jt Bone Spine 83(5):559–562
39.
Zurück zum Zitat Yamakawa K, Iwasaki H, Masuda I, Ohjimi Y, Honda I, Iyama K et al (2002) Cartilage intermediate layer protein expression in calcium pyrophosphate dihydrate crystal deposition disease. J Rheumatol 29:1746–1753PubMed Yamakawa K, Iwasaki H, Masuda I, Ohjimi Y, Honda I, Iyama K et al (2002) Cartilage intermediate layer protein expression in calcium pyrophosphate dihydrate crystal deposition disease. J Rheumatol 29:1746–1753PubMed
40.
Zurück zum Zitat Yang BY, Sartoris DJ, Resnick D, Clopton P (1996) Calcium pyrophosphate dihydrate crystal deposition disease: frequency of tendon calcification about the knee. J Rheumatol 23:883–888PubMed Yang BY, Sartoris DJ, Resnick D, Clopton P (1996) Calcium pyrophosphate dihydrate crystal deposition disease: frequency of tendon calcification about the knee. J Rheumatol 23:883–888PubMed
41.
Zurück zum Zitat Zadaka A, Gioe T, Gertner E (2010) Acute crystal-induced arthritis following arthroplasty. J Knee Surg 23:17–20PubMed Zadaka A, Gioe T, Gertner E (2010) Acute crystal-induced arthritis following arthroplasty. J Knee Surg 23:17–20PubMed
42.
Zurück zum Zitat Zhang W, Doherty M, Bardin T, Barskova V, Guerne PA, Jansen TL et al (2011) European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis 70:563–570PubMed Zhang W, Doherty M, Bardin T, Barskova V, Guerne PA, Jansen TL et al (2011) European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis 70:563–570PubMed
Metadaten
Titel
There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis
verfasst von
Jore H. Willems
Rachid Rassir
Inger N. Sierevelt
Peter A. Nolte
Publikationsdatum
24.09.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05725-7

Weitere Artikel der Ausgabe 9/2020

Knee Surgery, Sports Traumatology, Arthroscopy 9/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.