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TKA outcomes after prior bone and soft tissue knee surgery

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Bone surgery around the knee joint could represent a more traumatic prior surgical procedure compared to soft tissue knee surgery and may predispose to differing postoperative total knee arthroplasty (TKA) outcomes. The objective of this study was to analyse the postoperative results as well as complications and failures in two groups of patients that had undergone knee surgery prior to primary TKA (bone surgery and soft tissue surgery) when compared to the no prior surgery group.

Methods

A retrospective and cohort series of 1,474 primary TKA were evaluated at minimum follow-up period of 2 years: 1,119 primary TKA underwent no prior surgery (1,119 patients) (group A), 85 primary TKA (85 patients) (group B) had prior bone procedure [high tibial osteotomy (n = 64), tibial plateau fracture (n = 10) and patellar realignment (n = 11)], and third group of 146 primary TKA (146 patients) (group C) had undergone a soft tissue procedure [arthroscopy (n = 60) and menisectomy (n = 86)] before primary TKA. All the patients underwent a clinical and radiological evaluation as well as International Knee Society (IKS) scores.

Results

Preoperatively, group B had 40 % of cases classified as stage IV knee arthritis (p < 0.02); while 57 % of cases in group A showed higher levels of knee malalignment (p = 0.001) and group C had lower BMI (p = 0.001). Intraoperative complications revealed no difference. Although group B had the poorest postoperative mean values of knee flexion, TKA procedure improved the preoperative mean values of knee flexion in all the study groups. The postoperative complications were more prevalent in group C (p < 0.001), while the percentage of revision TKA was similar for all study groups (p = 0.5). At 120-month follow-up, the Kaplan–Meier survival curve rates showed no difference (p = 0.29).

Conclusion

This study confirms that prior knee surgery could be considered a clinical condition predisposed to higher postoperative complication rate in primary TKA compared to the no prior surgery group. After analysing the three study groups, group C showed a higher rate of postoperative local complications and lower IKS knee scores, while the group B showed the poorest postoperative mean values of knee flexion as well as the need for extended surgical approach (TTO approach) was more prevalent in this study group. However, statistical analysis did not reveal a direct correlation between the type of prior knee surgery and TKA failures.

Level of evidence

IV.

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References

  1. Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72

    Google Scholar 

  2. Anderson JG, Wixson RL, Tsai D, Stulberg SD (1996) Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty 11(7):831–840

    Article  PubMed  CAS  Google Scholar 

  3. Blackbourne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Jt Surg Br 59:241–242

    Google Scholar 

  4. Bruce WJ, Rooney J, Hutabarat SR, Atkinson MC, Goldberg JA, Walsh WR (2000) Exposure in difficult total knee arthroplasty using coronal tibial tubercle osteotomy. J Orthop Surg (Hong Kong) 8(1):61–65

    Google Scholar 

  5. Forrest L (1983) Current concepts in soft connective tissue wound healing. Br J Surg 70(3):133–140

    Article  PubMed  CAS  Google Scholar 

  6. Haslam P, Armstrong M, Geutjens G, Wilton TJ (2007) Total knee arthroplasty after failed high tibial osteotomy long-term follow-up of matched groups. J Arthroplasty 22(2):245–250

    Article  PubMed  Google Scholar 

  7. Hoxie SC, Dobbs RE, Dahm DL, Trousdale RT (2008) Total knee arthroplasty after anterior cruciate ligament reconstruction. J Arthroplasty 23(7):1005–1008

    Article  PubMed  Google Scholar 

  8. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  9. Kazakos KJ, Chatzipapas C, Verettas D, Galanis V, Xarchas KC, Psillakis I (2008) Mid-term results of total knee arthroplasty after high tibial osteotomy. Arch Orthop Trauma Surg 128:167–173

    Article  PubMed  Google Scholar 

  10. Larson AN, Hanssen AD, Cass JR (2009) Does prior infection alter the outcome of TKA after tibial plateau fracture? Clin Orthop Relat Res 467:1793–1799

    Article  PubMed  Google Scholar 

  11. Liu SH, Yang RS, al-Shaikh R, Lane JM (1995) Collagen in tendon, ligament, and bone healing. A current review. Clin Orthop Relat Res 318:265–278

    PubMed  Google Scholar 

  12. Madan S, Ranjith RK, Fiddian NJ (2002–2003) Total knee replacement following high tibial osteotomy. Bull Hosp Jt Dis. 61(1-2):5-10

    Google Scholar 

  13. Moreland JR, Bassett LW, Hanker GJ (1987) Radiographic analysis of the axial alignment of the lower extremity. J Bone Jt Surgery Am 69:745–749

    CAS  Google Scholar 

  14. Pagnano MW, Clarke HD, Jacofsky DJ, Amendola A, Repici JA (2005) Surgical treatment of the middle-aged patient with arthritic knees. Instr Course Lect 54:251–259

    PubMed  Google Scholar 

  15. Papadopoulos EC, Parvizi J, Lai CH, Lewallen DG (2002) Total knee arthroplasty following prior distal femoral fracture. Knee 9(4):267–274

    Article  PubMed  Google Scholar 

  16. Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, Mavrogenis AF, Korres DS, Soucacos PN (2006) Complications after tibia plateau fracture surgery. Injury 237(6):475–484

    Article  Google Scholar 

  17. Parvizi J, Hanssen AD, Spangehl MJ (2004) Total knee arthroplasty following tibial osteotomy: risk factors for failure. J Bone Jt Surg Am 86(3):474–479

    Google Scholar 

  18. Piedade SR, Pinaroli A, Servien E, Neyret P (2008) Tibial tubercle osteotomy in primary total knee arthroplasty: a safe procedure or not? Knee 15(6):439–446

    Article  PubMed  Google Scholar 

  19. Piedade SR, Pinaroli A, Servien E, Neyret P (2009) Revision after early aseptic failures in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17(3):248–453

    Article  PubMed  Google Scholar 

  20. Rozkydal Z, Pink T (2003) Total knee replacement following high tibial osteotomy. Acta Chir Orthop Traumatol Cech 70(3):158–163

    PubMed  CAS  Google Scholar 

  21. Sukuki G, Saito S, Ishii T, Motojima S, Tokuhashi Y, Ryu J (2011) Previous fracture surgery is a major factor after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(12):2040–2044

    Article  Google Scholar 

  22. Van Raaij TM, Bakker W, Reijaman M, Verhaar JA (2007) The effect of high tibial osteotomy on the results of total knee arthroplasty: a matched case control study. BMC Musculoskelet Disord 8:74

    Article  PubMed  Google Scholar 

  23. Weiss NG, Parvizi J, Trousdale RT, Bryce RD, Lewallen DG (2003) Total knee arthroplasty in patients with prior fracture of tibial plateau. J Bone Jt Surg Am 85(2):218–221

    Article  Google Scholar 

  24. Whiteside LA (1995) Exposure in difficult total knee arthroplasty using tibial tubercle osteotomy. Clin Orthop Relat Res 321:32–35

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Exercise and Sports Medicine Group, School of Medical Sciences, State University of Campinas, UNICAMP, Campinas, Brazil

    Sérgio Rocha Piedade

  2. Département d’Orthopedie du Genou, Centre Albert Trillat, Hôpital de la Croix Rousse, 103 Grande rue de la Croix Rousse, 69004, Lyon, France

    Alban Pinaroli, Elvire Servien & Philippe Neyret

Authors
  1. Sérgio Rocha Piedade
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  2. Alban Pinaroli
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  3. Elvire Servien
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  4. Philippe Neyret
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Corresponding author

Correspondence to Philippe Neyret.

Additional information

Sérgio Rocha Piedade: Post Doctorate Scholarship by CNPq—National Council for Scientific and Technological Development/Brazil.

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Piedade, S.R., Pinaroli, A., Servien, E. et al. TKA outcomes after prior bone and soft tissue knee surgery. Knee Surg Sports Traumatol Arthrosc 21, 2737–2743 (2013). https://doi.org/10.1007/s00167-012-2139-7

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  • DOI: https://doi.org/10.1007/s00167-012-2139-7

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