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TKA outcomes after prior bone and soft tissue knee surgery
Sérgio Rocha Piedade1, Alban Pinaroli, Elvire Servien
1Department of Orthopedics and Traumatology, Exercise and Sports Medicine Group, School of Medical Sciences, State University of Campinas, UNICAMP, Campinas, Brazil, piedade@unicamp.br.
Summary
Prior knee surgery, particularly soft tissue procedures, increases complication rates after total knee arthroplasty (TKA). Bone surgery impacts knee flexion, but neither prior surgery type directly correlates with TKA failure.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Biomechanical Engineering
Background:
- Prior knee surgery can influence total knee arthroplasty (TKA) outcomes.
- Bone surgery may represent a more complex prior procedure than soft tissue surgery.
- Understanding these differences is crucial for managing TKA expectations and results.
Purpose of the Study:
- To compare postoperative TKA outcomes, complications, and failures in patients with prior bone or soft tissue knee surgery versus those with no prior surgery.
- To analyze the impact of different types of prior knee procedures on TKA results.
Main Methods:
- Retrospective cohort study of 1,474 primary TKA patients.
- Groups: no prior surgery (n=1,119), prior bone surgery (n=85), prior soft tissue surgery (n=146).
- Clinical, radiological evaluation, and International Knee Society (IKS) scores assessed at minimum 2-year follow-up.
Main Results:
- Prior bone surgery group (B) had higher rates of Stage IV arthritis; prior soft tissue group (C) had lower BMI.
- Group C showed more postoperative complications (p < 0.001); Group B had poorer knee flexion.
- No significant difference in revision TKA rates or 120-month survival across groups.
Conclusions:
- Prior knee surgery is associated with a higher postoperative complication rate in primary TKA.
- Soft tissue procedures (Group C) led to more local complications and lower IKS scores.
- Bone procedures (Group B) resulted in worse knee flexion, but no direct correlation found between prior surgery type and TKA failure.