Intraoperative Incidental Findings In Total Knee Arthroplasty: A Systematic Review
Ali Yeganeh, Ava Parvandi, Alireza Mirahmadi, Mahdi Sajedifar, Donya Rezazadeh Eidgahi, Mahsa Mortazavi, Shayan Amiri, Mengnai Li, Ara NazarianObjectives
During total knee arthroplasty (TKA), there is a possibility of discovering incidental findings that do not present any symptoms or signs during routine preoperative assessments. Awareness of these incidental findings enables us to appropriately manage knee arthroplasty and make informed decisions based on the patient’s condition.
Methods
A systematic review was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive searches were conducted across multiple databases, including PubMed, Scopus, Embase, and Web of Science, using a combination of Medical Subject Headings (MeSH) and free-text terms related to knee arthroplasty and incidental findings. Studies were screened for eligibility according to predefined inclusion criteria, and two reviewers independently extracted data.
Results
The systematic review followed a series of well-defined steps. After assessing the full text of the selected studies, 13 studies involving 26 patients were identified. These studies included case reports of patients who underwent TKA, where unexpected knee conditions not identified during routine preoperative assessments were discovered intraoperatively. The incidental findings reported in these studies included lipoma arborescens, metastatic mammary carcinoma, black cartilage (Alkaptonuria), tenosynovial giant cell tumor, synovial sarcoma, non-Hodgkin lymphoma, Chondrosclerosis, tuberculosis of the joint, and pigmented bone.
Conclusion
Incidental findings that do not exhibit symptoms or signs during routine preoperative assessments can complicate the TKA procedure. Awareness of these findings allows for effective management of knee arthroplasty and facilitates optimal decision-making for the patient’s well-being based on their specific condition.