Prior Knee Arthroscopy Increases the Failure Rate of Subsequent Unicompartmental Knee Arthroplasty |
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Authors: | Safa C Fassihi Alex Gu Lauren E Wessel Savyasachi C Thakkar Peter K Sculco Michael P Ast |
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Institution: | 1. Department of Orthopaedic Surgery, George Washington University, Washington, DC;2. The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY;3. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY;4. Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, Columbia, MD |
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Abstract: | BackgroundIn selected patients, knee arthroscopy is performed prior to unicompartmental knee arthroplasty (UKA) to treat symptomatic mechanical pathology, delay arthroplasty, and assess the knee compartments. The purpose of this study was to determine if knee arthroscopy prior to UKA is associated with increased rates of UKA failure or conversion to total knee arthroplasty (TKA).MethodsData was collected from the Humana insurance database from 2007-2017. Patients who underwent knee arthroscopy within two years prior to UKA were identified and matched with controls based on age, gender, Charlson Comorbidity Index, smoking status, and obesity. Rates of conversion to TKA and failure for various causes were compared between cohorts.ResultsPrior to propensity matching, 8353 UKA patients met inclusion criteria. Of these, 1079 patients (12.9%) underwent knee arthroscopy within two years of UKA and were matched to 1079 patients (controls) who did not undergo knee arthroscopy in the two years preceding UKA. No differences in demographics/comorbidities existed among cohorts. Compared to controls, the knee arthroscopy cohort was more likely to experience failure for aseptic loosening (2.4% vs 1.1%; OR 2.166; P = .044) and significantly more likely to require conversion to TKA (10.4% vs 4.9%; OR 2.113; P < .001) within two years of UKA.ConclusionKnee arthroscopy within two years of UKA is associated with an increased rate of UKA conversion to TKA and a higher rate of UKA failure from aseptic loosening. Although clinicians should be mindful of this association when performing knee arthroscopy in patients who may be indicated for future UKA, further research is needed to better characterize these findings. |
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Keywords: | knee arthroscopy unicompartmental knee arthroplasty revision conversion total knee arthroplasty failure |
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