History of previous knee surgery does not affect the clinical outcomes of primary total knee arthroplasty in an Asian population.
BACKGROUND
Patients with a history of previous knee surgeries, such as anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO), often have a higher likelihood of requiring a subsequent total knee arthroplasty (TKA). However, there is relatively limited data, especially in the Asian population, on how previous knee surgery could affect the clinical outcomes of TKA. Therefore, this study aims to evaluate the impact of previous knee surgeries on the clinical outcomes of future TKA.


METHODS
We reviewed the prospectively-collected data of 303 patients who underwent TKA by a single surgeon from a total joint registry of a tertiary hospital over a period of 5 years. Those with a history of previous knee surgery were identified. The SF-36 Health Survey, Oxford Knee Score (OKS) and Knee Society Score (KSS) were used to evaluate clinical outcomes pre-operatively, at 6 months and 2 years.


RESULTS
Previous knee surgery did not have a significant impact on the patients' pre-operative baseline clinical scores and body mass index (BMI). Patients with a history of knee surgery undergo TKA at a significantly younger age (mean of 6.6 years younger). On follow-up, patients with a history of knee surgery have similar post-operative outcome scores as those without previous knee surgery. Also, a high proportion of these patients are satisfied with their post-operative results and feel that their expectations have been met.


CONCLUSIONS
Patients with previous knee surgery had TKA at a significantly younger age than those without. But these patients have similar clinical and quality of life outcomes after TKA. In addition, a high proportion of these patients are satisfied with the results of surgery and feel that their expectations of TKA are met. This is important for clinicians when counselling patients pre-operatively.
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169865, Singapore.
Jason Beng Teck
JB
Lim
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169865, Singapore.
Bryan
B
Loh
Orthopaedics Diagnostic Centre, Singapore General Hospital, Singapore 169865, Singapore.
Hwei Chi
HC
Chong
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169865, Singapore.
Andrew Hwee Chye
AH
Tan
Primary total knee arthroplasty (TKA); clinical outcomes; previous knee surgery; satisfaction
J Bone Joint Surg Am. 2014 Jan 15;96(2):144-50
24430414
Arch Orthop Trauma Surg. 2009 Mar;129(3):409-15
19050905
Acta Orthop. 2008 Apr;79(2):230-4
18484249
BMC Musculoskelet Disord. 2009 Jul 20;10:88
19619275
Best Pract Res Clin Rheumatol. 2006 Aug;20(4):721-40
16979535
J Bone Joint Surg Am. 2014 May 21;96(10):801-5
24875020
Adv Orthop. 2015;2015:928301
25954533
Ann Intern Med. 2001 Oct 16;135(8 Pt 2):711-21
11601954
J Bone Joint Surg Am. 1997 Apr;79(4):575-82
9111404
Cartilage. 2013 Jul;4(3 Suppl):22S-6S
26069662
J Bone Joint Surg Am. 1998 Feb;80(2):163-73
9486722
Arthroscopy. 2008 Aug;24(8):899-908
18657738
J Arthroplasty. 1989;4 Suppl:S11-7
2584982
J Bone Joint Surg Am. 2014 Jan 1;96(1):2-10
24382718
Acta Orthop. 2010 Aug;81(4):413-9
20809740
Int Orthop. 2011 Jul;35(7):1093-7
21287172
J Arthroplasty. 1999 Dec;14(8):969-75
10614889
J Bone Joint Surg Am. 2008 Nov;90(11):2337-45
18978402
Clin Orthop Relat Res. 2007 Nov;464:83-7
17589362
Am J Sports Med. 2007 Oct;35(10 ):1756-69
17761605
Sports Med. 1999 Mar;27(3):143-56
10222538