Total Knee Arthroplasty in Postpolio Residual Paralysis: A Systematic Review and Pooled Analysis of Its Outcomes and Complications.
Anil Regmi, Surakshya Baral, Ravi Saini et al.
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In 30 seconds
This systematic review and pooled analysis assessed complications and revision after total knee arthroplasty (TKA) in patients with postpolio residual paralysis. It included 12 studies comprising 272 knees. The pooled overall complication rate was 16% (95% CI, 9 to 26), and revision surgery occurred in 8% of knees (95% CI, 4 to 15). Instability or residual recurvatum and periprosthetic fracture were the most common reported complications. Outcomes varied across studies, with moderate-to-high heterogeneity for complications and revisions.
Key findings
- Across 12 studies and 272 knees, the pooled complication rate was 16% (95% CI, 9 to 26).
- Revision surgery occurred in 8% of knees (95% CI, 4 to 15).
- Instability or residual recurvatum occurred in 5%, and periprosthetic fractures in 2%.
- Heterogeneity was moderate to high for complications and revisions (I 2 = 58 to 72%, P ≤ 0.01).
Why it matters
TKA can provide satisfactory outcomes in patients with postpolio residual paralysis, but the pooled findings indicate meaningful risks of complications and revision. Instability, recurvatum, and periprosthetic fracture are particularly relevant when considering expected outcomes and planning surgery. Variation across the included cohorts also means pooled estimates should be interpreted in light of differing reported outcomes.
What to keep in mind
The analysis pooled 12 studies with moderate-to-high heterogeneity in complications and revisions, indicating variability across cohorts.