Factors associated with arthrofibrosis-related revision following 14,325 total or unicompartmental knee arthro-plasties: an analysis from the Dutch Arthroplasty Registry.

Background and purpose:  Arthrofibrosis is a fibrotic joint disorder that can impair the results of knee arthroplasty surgery by limiting the range of motion, functionality, and quality of life. We aimed to investigate whether patient and procedural characteristics are associated with arthrofibrosis-related revision following unicompartmental and total knee arthroplasty (UKA and TKA).

Methods:  A prospective observational study was conducted using data from the Dutch Arthroplasty Registry. We included 14,325 revisions performed in 2014-2022 following primary knee arthroplasty. Demographic and surgical characteristics including age, sex, BMI, smoking status, and prosthesis type (TKA versus UKA) were analyzed. Multiple logistic regression was performed to investigate associations between these factors and arthrofibrosis-related revisions, compared with other reasons.

Results:  Revisions were due to arthrofibrosis in 711 (5%) patients. There were significantly higher associations for younger age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96-0.97)), male sex (OR 1.2, CI 1.0-1.4), lower BMI (OR 0.97, CI 0.95-0.98), non-smoking status (OR 1.7, CI 1.2-2.3), and TKA (OR 7.7, CI 5.2-12), for arthrofibrosis-related revision compared with any other reason for revision.

Conclusion: Younger patients, men, non-smokers, patients with a lower BMI, and those who had primary TKA were more often associated with revision due to arthrofibrosis than other reasons for revision.