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Knee

IMPACT OF PERIVASCULAR LYMPHOCYTIC INFILTRATION IN ASEPTIC TOTAL KNEE REVISION

The Knee Society (TKS) 2020 Members Meeting, held online, 10–12 September 2020.



Abstract

Background

A limited number of investigations with conflicting results have described perivascular lymphocytic infiltration (PVLI) in the setting of total knee arthroplasty. The purpose of this study was to determine if PVLI found in total knee replacements at the time of aseptic revision surgery was associated with worse clinical outcomes and survivorship.

Methods

A retrospective review was conducted on 617 patients that underwent aseptic total knee arthroplasty revision who had histologic analysis for PVLI at the time of surgery. Clinical and radiographic data was obtained pre and postoperatively, 6 weeks post operatively, and then every year thereafter.

Results

Within this cohort, 118 patients (19.1%) were found to have PVLI on histologic analysis. A higher incidence of PVLI was noted in female patients (p = 0.037) and those patients with a preoperative diagnosis of unexplained pain (p=0.002). Re-revision was performed on 83 patients (13.4%) with no significant differences in all-cause or aseptic revisions between groups. There was no significant difference in range of motion improvement (p = 0.54), or improvement of KSC (p = 0.66), KSP (p = 0.61), or KSF (p = 0.3) clinical outcome scores between PVLI and no PVLI sub-groups.

Conclusion

Perivascular lymphocytic infiltration found on large-scale histologic analysis in total knee replacements at aseptic revision surgery was not associated with worse clinical outcomes or difference in revision rates.