263 / 324
RESULTS
Statistical analysis of postoperative complica-
tions revealed that group B had a higher post-
operative 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 bet-
ween arthroscopy and PTKA was 53 months.
However, statistical analysis did not reveal a
direct correlation between arthroscopy/ PTKA
interval and postoperative complica-
tions/failures (p=0.55). The Kaplan-Meier sur-
vival curves showed a survival rate of 98.1%
and 86.8% at 10 years follow-up for group A
and B, respectively.
CONCLUSION
Our data allow us to conclude that prior knee
arthroscopy should be considered a factor rela-
ted to postoperative PTKA outcomes as
demonstrated by the higher rate of postopera-
tive complications and failures (p<0.001) as
well as a worse survival curve than group A.
14
es
JOURNÉES LYONNAISES DE CHIRURGIE DU GENOU
262
TOTAL KNEE ARTHROPLASTY
AFTER PRIOR KNEE SURGERY
INTRODUCTION
In orthopedic literature, several reports have
been published regarding primary total knee
arthroplasty performed after prior knee surge-
ry such as proximal tibial osteotomy, fractures
around the knee, anterior cruciate ligament
reconstruction and even arthroscopy.
With regard to postoperative outcomes, the
prior knee surgery trauma energy could be a
factor to be analyzed. Hence, taking into
consideration type of prior knee surgery, whe-
ther bone or soft tissue procedure: can we
expect different primary TKA postoperative
outcomes?
MATERIALAND
METHODS
A retrospective and cohort series of 1,474
PTKA were evaluated at minimum follow-up
period of 2 years: 1,119 PTKA underwent no
prior surgery (1035) (
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 realign-
ment (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
(table 1). The total knee prosthesis used was
the posterior-stabilized tricompartmental TKA
with one third medial condyle (T
ORNIER
®,
Saint Ismier, France). All the patients under-
went a clinical and radiological evaluation as
well as IKS scores.
RESULTS
Preoperatively,
group B
had 40% of cases clas-
sified 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). However, no diffe-
rence was found in terms of pain level and
patella height. Similarly, intra operative com-
plications revealed no difference.