Preoperative Diagnosis Can Predict Conversion Total Knee Arthroplasty Outcomes

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Trauma Surgery

Background:

• Conversion total knee arthroplasty (TKA) in post-traumatic knees presents challenges compared to primary TKA for osteoarthritis.
• Previous knee trauma and surgery significantly impact outcomes in conversion TKA procedures.

Purpose of the Study:

• To determine the influence of post-traumatic osteoarthritis and prior knee surgery on conversion TKA outcomes.
• To compare outcomes between conversion TKA following fractures versus soft-tissue knee trauma.

Main Methods:

• Retrospective analysis of 72 conversion TKA cases with prior knee trauma.
• Patients categorized into postfracture (n=27) and soft-tissue trauma (n=45) groups.
• Comparison of implant costs, length of stay, complications, readmissions, and reoperations; subanalysis on prior surgery effects.

Main Results:

• The postfracture TKA group had significantly higher early surgical site complications (22% vs. 4.4%) and 90-day readmissions (14.8% vs. 2.2%).
• No significant differences in operative time, total implant costs, length of stay, medical complications, 30-day readmissions, or 90-day reoperations.
• Multiple prior knee surgeries correlated with younger patients, better health, and more expensive implants; prior ORIF linked to more complications than arthroscopy.

Conclusions:

• Site-specific fractures increase the likelihood of surgical site complications and 90-day readmissions post-conversion TKA compared to soft-tissue trauma.
• Multiple prior knee surgeries independently predict the selection of costlier implants, regardless of the initial diagnosis.