Lumbar spinal stenosis impairs function following total knee arthroplasty

Lumbar spinal stenosis is a common cause of lower back and leg pain in older adults. Stenosis is not considered a contraindication for total knee arthroplasty (TKA); however, it is unclear whether it is associated with less than optimal postoperative outcomes. In a multicenter review of TKAs, 115 patients with lumbar disease were matched by age, gender, body mass index, type of procedure, and length of follow-up to patients who did not have stenosis. Spinal stenosis was found to be associated with significantly lower Knee Society objective and function scores compared with patients without stenosis. There was no observed difference in the revision rates (1%) or radiographic outcomes. Surgeons should consider cautioning patients that they can expect relief of arthritic symptoms following TKA, but they may continue to experience limitations in postoperative function relative to their expectations.