Knee Arthroscopy Prior to Revision TKA Is Associated with Increased Re-Revision for Stiffness

Abstract

AbstractThis is an experimental study. As knee arthroscopy may be used as a suitable temporizing alternative prior to revision surgery, knee arthroscopy potentially may be a risk factor for subsequent adverse outcomes after revision total knee arthroplasty (TKA). This study aimed to evaluate the impact of prior knee arthroscopy on outcomes of subsequent TKA revision surgery. We identified 1,689 consecutive patients who underwent revision TKA: (1) patients with no prior knee arthroscopy (n = 1,549) and (2) patients with knee arthroscopy prior to revision TKA (n = 140). A control group of matched revision TKA patients who did not undergo prior knee arthroscopy was identified (700 patients), using one-to-five matching. Matched patients with prior knee arthroscopy demonstrated an increased likelihood of requiring re-revision (odds ratio [OR], 2.06, p < 0.001), particularly for stiffness (OR, 2.72, p < 0.02) compared with patients who underwent revision TKA without prior knee arthroscopy. Knee arthroscopy demonstrated a time-dependent impact on revision TKA outcomes, with an increased likelihood of requiring re-revision for patients who underwent knee arthroscopy within 6 months prior to revision TKA compared with patients who underwent knee arthroscopy within 6 to 12 months prior to revision TKA (OR, 3.16, p < 0.04). This cohort matched study shows that patients who had prior knee arthroscopy demonstrated a significantly higher likelihood of requiring re-revision compared with patients who underwent revision TKA without prior knee arthroscopy. Additionally, there was a significant increased likelihood in requiring re-revision for patients who had prior knee arthroscopy within 6 months. This provides clinically useful information for counseling of patients who are considering temporizing their symptoms with knee arthroscopy prior to revision TKA.