Will pre-existing dermatitis affect the decision to proceed with total knee replacement (TKR) surgery?

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Last updated: February 8, 2025View editorial policy

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From the Research

Pre-Existing Dermatitis and Total Knee Replacement Surgery

  • The decision to proceed with total knee replacement (TKR) surgery may be affected by pre-existing dermatitis, as certain dermatological conditions can increase the risk of post-operative complications 1.
  • Studies have shown that patients with psoriasis, a chronic inflammatory skin condition, are at a higher risk of developing deep surgical site infections (SSIs) and wound complications after TKR surgery 1.
  • Other forms of dermatitis, such as allergic contact dermatitis, can also occur after TKR surgery, particularly in response to metal ions released from implants or topical therapies 2, 3.
  • However, the presence of pre-existing dermatitis does not necessarily preclude patients from undergoing TKR surgery, and individual cases should be evaluated on a case-by-case basis.

Specific Dermatological Conditions and TKR Surgery

  • Psoriasis: associated with an increased risk of deep SSIs and wound complications after TKR surgery 1.
  • Allergic contact dermatitis: can occur in response to metal ions released from implants or topical therapies, and may require revision surgery in severe cases 2, 3.
  • Traumatic eczematous dermatitis (SKINTED): a rare complication of TKR surgery, characterized by eczematous lesions around the surgical incision site, and can be treated with topical corticosteroids and emollients 4, 5.

Implications for Clinical Practice

  • Patients with pre-existing dermatitis should be carefully evaluated and counseled before undergoing TKR surgery, to assess their individual risk of post-operative complications 1.
  • Surgeons and dermatologists should be aware of the potential for dermatological complications after TKR surgery, and work together to diagnose and manage these conditions effectively 4, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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