Abstract：
BACKGROUND: Arthrofibrosis following total knee arthroplasty (TKA) and adhesive capsulitis (AC) of the shoulder develop via a similar pathologic process. The purpose of this study was to examine the relationship between these two conditions.
METHODS: This was a retrospective cohort study using a large nationwide claims database. Patients who had a history of shoulder AC prior to TKA were compared to TKA patients who did not have AC history comparing rates of postoperative stiffness, manipulation under anesthesia (MUA), arthroscopic lysis of adhesions (LOAs), and revision arthroplasty at postoperative timepoints (3 months, 6 months, 1 year, and 2 years).
RESULTS: Within 3 months, 6 months, 1 year, and 2 years of their TKAs, patients who had a history of AC prior to TKA were significantly more likely to experience stiffness (OR [odds ratio] = 1.29, 1.28, 1.32, and 1.36, respectively) and LOAs (OR = 6.78, 3.65, 2.99, and 2.81, respectively). They also showed increased risk of MUA within 6 months, 1 year, and 2 years (OR = 1.15, 1.15, and 1.16, respectively) of their TKAs. Patients having a preoperative diagnosis of AC did not have an increased risk of undergoing revision surgery 1 year or 2 years after their TKAs (P > .05).
CONCLUSIONS: Patients diagnosed with AC prior to TKA experience higher rates of postoperative stiffness, resulting in additional interventions such as MUA and LOAs. These findings identify a particularly high-risk patient population that may benefit from additional interventions prior to and following TKA.
METHODS: This is a level III prognostic study.
METHODS: This was a retrospective cohort study using a large nationwide claims database. Patients who had a history of shoulder AC prior to TKA were compared to TKA patients who did not have AC history comparing rates of postoperative stiffness, manipulation under anesthesia (MUA), arthroscopic lysis of adhesions (LOAs), and revision arthroplasty at postoperative timepoints (3 months, 6 months, 1 year, and 2 years).
RESULTS: Within 3 months, 6 months, 1 year, and 2 years of their TKAs, patients who had a history of AC prior to TKA were significantly more likely to experience stiffness (OR [odds ratio] = 1.29, 1.28, 1.32, and 1.36, respectively) and LOAs (OR = 6.78, 3.65, 2.99, and 2.81, respectively). They also showed increased risk of MUA within 6 months, 1 year, and 2 years (OR = 1.15, 1.15, and 1.16, respectively) of their TKAs. Patients having a preoperative diagnosis of AC did not have an increased risk of undergoing revision surgery 1 year or 2 years after their TKAs (P > .05).
CONCLUSIONS: Patients diagnosed with AC prior to TKA experience higher rates of postoperative stiffness, resulting in additional interventions such as MUA and LOAs. These findings identify a particularly high-risk patient population that may benefit from additional interventions prior to and following TKA.
METHODS: This is a level III prognostic study.
摘要：
背景：全膝关节置换术（TKA）后的关节纤维化和肩关节粘连囊炎（AC）通过相似的病理过程发展。这项研究的目的是检查TKA术后僵硬度与先前诊断肩关节粘连性囊炎之间的关系。
方法：这是一项使用大型全国性索赔数据库的一对一最近邻倾向匹配回顾性队列研究。使用多变量logistic回归比较术后僵硬率，将TKA之前有肩关节AC病史的患者与没有AC病史的TKA患者进行比较。麻醉下操作（MUA），关节镜下粘连松解术（LOA），和术后时间点的关节翻修术(3个月，6个月,1年,和2年）。
结果：在3个月内，6个月,他们TKA的1年和2年，在TKA之前有AC病史的患者明显更可能出现僵硬(OR[赔率比]分别为1.29,1.28,1.32,1.36)和LOA(OR分别为6.78,3.65,2.99,2.81).他们还显示6个月内MUA的风险增加，1年,和他们的TKA的2年(OR分别=1.15、1.15、1.16)。术前诊断为AC的患者在TKA术后1年或2年接受翻修手术的风险没有增加(P>0.05)。
结论：TKA前诊断为粘连性囊炎的患者术后僵硬率较高，导致额外的干预措施，如MUA和LOA。这些发现确定了一个特别高风险的患者群体，他们可能受益于TKA之前和之后的其他干预措施。
方法：这是一项III级预后研究。
方法：这是一项使用大型全国性索赔数据库的一对一最近邻倾向匹配回顾性队列研究。使用多变量logistic回归比较术后僵硬率，将TKA之前有肩关节AC病史的患者与没有AC病史的TKA患者进行比较。麻醉下操作（MUA），关节镜下粘连松解术（LOA），和术后时间点的关节翻修术(3个月，6个月,1年,和2年）。
结果：在3个月内，6个月,他们TKA的1年和2年，在TKA之前有AC病史的患者明显更可能出现僵硬(OR[赔率比]分别为1.29,1.28,1.32,1.36)和LOA(OR分别为6.78,3.65,2.99,2.81).他们还显示6个月内MUA的风险增加，1年,和他们的TKA的2年(OR分别=1.15、1.15、1.16)。术前诊断为AC的患者在TKA术后1年或2年接受翻修手术的风险没有增加(P>0.05)。
结论：TKA前诊断为粘连性囊炎的患者术后僵硬率较高，导致额外的干预措施，如MUA和LOA。这些发现确定了一个特别高风险的患者群体，他们可能受益于TKA之前和之后的其他干预措施。
方法：这是一项III级预后研究。
