2023 ISAKOS Biennial Congress ePoster
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction
Brian Rao, BS, Toledo, Ohio UNITED STATES
Alex C. Dibartola, MD, MPH, Columbus, OH UNITED STATES
Eric Milliron, BS, Columbus, Ohio UNITED STATES
Parker Cavendish, BS, Columbus, Ohio UNITED STATES
James C. Kirven, BS, Columbus, OH UNITED STATES
Spencer E. Talentino, MD, Columbus, OH UNITED STATES
Charles Qin, MD, Columbus , OH UNITED STATES
Ryan H. Barnes, MD, Columbus, OH UNITED STATES
Robert A. Duerr, MD, St Louis, MO UNITED STATES
Christopher C. Kaeding, MD, Columbus, OH UNITED STATES
Robert A Magnussen, MD, MPH, Worthington, OH UNITED STATES
David C. Flanigan, MD, Columbus, OH UNITED STATES
The Ohio State University, Columbus, OH, UNITED STATES
FDA Status Not Applicable
Summary
Functional outcomes scores of KSKS and KSFS following TKA were not significantly different between the ACLR and control groups and TKA proves to be safe and effective in patients with previous ACLR with no statistically significant greater risk of wound complications, revisions, infections, or reoperation for any reason.
ePosters will be available shortly before Congress
Abstract
Introduction
As the incidence of knee injuries increases in the United States, the number of anterior cruciate ligament reconstructions and revisions (ACLR) also increases. History of ACLR greatly increases the risk of knee osteoarthritis and eventual total knee arthroplasty (TKA). Current literature on TKA following ACLR is scarce and mostly limited in number of patients and to single institutions. The purpose of this review is to compare the outcomes of TKAs following previous ACLR versus no previous ACLR, and to determine if previous ACLR has any effect.
Methods
This study was a systematic review involving retrospective studies. Research databases PubMed, Cochrane, EMBASE, and CINAHL were searched and articles involving outcome data for patients with TKA following an ipsilateral ACL reconstruction or revision were included. Outcomes data was compared amongst the two groups of patients and statistical analysis was performed utilizing Review Manager 5.4 (p-value of 0.05).
Results
Seven retrospective case-control studies with a total of 622 patients (253 males, 181 females, 188 unspecified) with a history of previous ACLR before TKA and 1026 matched controls were included in this review. Chi2 tests revealed no differences in intervention effects across any of the studies for wound complications, revisions, infections, reoperation for any reason, Knee Society Knee Scores (KSKS), or Knee Society Function Scores (KSFS) (p = 0.25, 0.57, 0.50, 0.26, 0.35, 0.08, respectively). Z-tests for the same outcomes revealed no significant differences between the ACLR and no ACLR groups (p = 0.08, 0.62, 0.15, 0.12, 0.33, 0.97, respectively). Mean operative time of TKA was 97.34 minutes in patients with previous ACLR and 89.15 minutes in patients with no previous ACLR (p = <0.0001).
Conclusion
Functional outcomes scores of KSKS and KSFS following TKA were not significantly different between the ACLR and control groups. However, there was a greater mean operative time in patients with previous ACLR. Despite this longer operative time, TKA proves to be safe and effective in patients with previous ACLR with no statistically significant greater risk of wound complications, revisions, infections, or reoperation for any reason. More research should be conducted with matched controls using a broader range of functional scores to compare between studies.