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Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction

2023 Congress Paper Abstracts
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Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction

Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES

The Ohio State University, Columbus, OH, UNITED STATES


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL


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.


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.


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