title: Is previous knee arthroscopy related to worse results in primary total knee arthroplasty?
abstract: According to literature, knee arthroscopy is a minimal invasive surgery performed for minor surgical trauma, reduced morbidity and shortens the hospitalization period. Therefore, this type of surgery before total knee arthroplasty (TKA) could be considered a minor procedure with minimum postoperative complication. A retrospective and cohort series of 1,474 primary TKA was performed with re-assessment after a minimum follow-up period of 2 years: 1,119 primary TKA had no previous surgery (group A) and 60 primary TKA had arthroscopic debridement (group B). All the patients underwent a clinical and radiological evaluation as well as IKS scores. Statistical analysis of postoperative complications revealed that group B had a higher postoperative complication rate (P < 0.01). In this group, 30% of local complications were re-operated and 8.3% of these cases underwent revision TKA (P < 0.01). The mean interval between arthroscopy and primary TKA was 53 months. However, statistical analysis did not reveal a direct correlation between arthroscopy/primary TKA interval and postoperative complications/failures (P = 0.55). The Kaplan-Meier survival curves showed a survival rate of 98.1 and 86.8% at 10 years follow-up for groups A and B, respectively. Our data allow us to conclude that previous knee arthroscopy should be considered a factor related to postoperative primary TKA outcomes as demonstrated by the higher rate of postoperative complications and failures (P < 0.001) as well as a worse survival curve than group A.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, State University of Campinas, UNICAMP, Campinas, Brazil. piedade@unicamp.br
authors.forename: Sérgio Rocha
authors.initials: SR
authors.lastname: Piedade
authors.forename: Alban
authors.initials: A
authors.lastname: Pinaroli
authors.forename: Elvire
authors.initials: E
authors.lastname: Servien
authors.forename: Philippe
authors.initials: P
authors.lastname: Neyret
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D003646:Debridement / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010329:Patella / Q000000981:diagnostic imaging; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult