{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:48:40Z","timestamp":1793911720038,"version":"4.8.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T00:00:00Z","timestamp":1560384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with pre\u2010existing lymphedema who undergo total knee arthroplasty\u00a0(TKA) for osteoarthritis\u00a0(OA) are at high risk for periprosthetic joint infection. This complication usually requires removal of the implant. This study aimed to investigate whether surgical treatment of lymphedema reduces the rate of prosthesis removal in such patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We retrospectively reviewed our prospective database of patient information collected between January 2009 and December 2018. A total of 348 cases of lower extremity lymphedema were reviewed, and those who underwent total knee TKA for OA of the knee were included. Patient demographics, clinical data, lymphedema surgical history, and TKA surgical history including any episodes of removal were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were nine of 15 lymphedema patients with knee OA who subsequently underwent TKA. The mean patient age was 70.4\u2009\u00b1\u20097.1\u2009years. A total of 18 TKAs were performed in nine patients. The knee prosthesis removal rate was 66.7% (12\/18). The prosthesis removal rate was 40% (2\/5) in patients who underwent lymphedema microsurgery vs 76.9% (10\/13) for those who did not (<jats:italic>P<\/jats:italic>\u2009=\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010existing lymphedema is associated with a high rate of knee prosthesis removal. Lymphedema microsurgery reduced the removal rate of knee prostheses. We recommend that lymphedema microsurgery be considered for patients who require TKA as a treatment for of the knee.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25517","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T04:01:00Z","timestamp":1560484860000},"page":"57-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Lymphedema microsurgery reduces the rate of implant removal for patients who have pre\u2010existing lymphedema and total knee arthroplasty for knee osteoarthritis"],"prefix":"10.1002","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9755-2594","authenticated-orcid":false,"given":"Tsz Yin","family":"Voravitvet","sequence":"first","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, Chang Gung University College of Medicine Taoyuan Taiwan"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Lerdsin Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-3461","authenticated-orcid":false,"given":"Courtney","family":"Chen","sequence":"additional","affiliation":[{"name":"Medical Doctor Candidate, UC San Diego School of Medicine San Diego California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-034X","authenticated-orcid":false,"given":"Chia\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for Tissue Engineering, Chang Gung Memorial Hospital Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-2959","authenticated-orcid":false,"given":"Ming\u2010Huei","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, Chang Gung University College of Medicine Taoyuan Taiwan"},{"name":"Center for Tissue Engineering, Chang Gung Memorial Hospital Taoyuan 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