Knee Arthroplasty with Prior Ligamentous Knee Surgery: A Matched Case-Control Study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Prior ligamentous knee surgery (LKS) may influence outcomes of total knee arthroplasty (TKA).
• Understanding the impact of previous LKS on TKA is crucial for patient selection and surgical planning.

Purpose of the Study:

• To evaluate the timing, operative details, and outcomes of TKA in patients with a history of LKS.
• To compare TKA outcomes in patients with and without prior LKS.

Main Methods:

• A retrospective review of a prospectively collected database identified 39 patients undergoing TKA with prior LKS.
• Patients were matched 2:1 to 78 control patients without prior LKS based on age, sex, and BMI.
• Outcomes assessed included implant type, need for hardware removal, complications, revision rates, and functional scores.

Main Results:

• Significantly more posterior stabilized implants were used in the LKS group (74.3% vs. 34.6%).
• Hardware removal was required in 38.4% of the LKS group.
• While complication and re-operation rates were higher in the LKS group, the differences were not statistically significant.
• Functional outcomes and range of motion were similar between groups.

Conclusions:

• TKA following LKS frequently necessitates hardware removal and the use of more constrained implants.
• Patients with prior LKS undergoing TKA exhibit a trend towards higher complication rates and increased need for subsequent surgery, particularly for post-TKA stiffness.