Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty. 2017 Dec;32(12):3626-3631. doi: 10.1016/j.arth.2017.06.052. Epub 2017 Jul 8.
Arthroscopic knee surgery frequently precedes total knee arthroplasty (TKA). There have been mixed data on the effect of prior arthroscopic surgery on results of TKA. The purpose of this study was to compare the 10-year Knee Society Score (KSS), survivorship, and complications of TKA in a cohort of patients who had a previous knee arthroscopy to a control cohort.
A retrospective review of 1315 TKAs who underwent a primary TKA between 2003 and 2004 was performed. Of these, 160 TKAs had previous arthroscopy (excluding ligamentous reconstruction). A matched cohort study 2:1 was carried out with a group of 320 controls (no prior surgery). Outcomes were assessed with the original KSS, range-of-motion, complications, and survivorships. Mean follow-up was 9 years.
The mean KSS increased from 36-84 in the arthroscopy group vs 35-86 in the control group (P = .5). The mean preoperative and postoperative range-of-motion was not different between groups (P = .2). The survivorship free of complication at 5 years was similar in both groups (94.3% in arthroscopy group vs. 95.3% in the control; P = .7) with infection in 2 controls and 3 arthroscopy cases (P = .2). The survivorships free of revision for aseptic loosening, revision for any reason, and reoperation were similar at 10 years (96.5%, 94.6%, and 89.2%, respectively, in the arthroscopy group vs 96.2%, 95.9%, and 91.5% in the control group).
There were no significant differences between both groups. These data are reassuring and valuable in an era in which many candidates for TKA will have had previous arthroscopic knee surgery.
关节镜膝关节手术常常先于全膝关节置换术(TKA)进行。先前的关节镜手术对 TKA 结果的影响数据不一。本研究旨在比较一组曾行膝关节镜检查的患者与对照组患者的 TKA 术后 10 年膝关节学会评分(KSS)、生存率和并发症。
对 2003 年至 2004 年间行初次 TKA 的 1315 例患者进行回顾性研究。其中,160 例 TKA 之前有过关节镜检查(不包括韧带重建)。对 2:1 的匹配队列研究进行了 320 例对照组(无既往手术)。采用原始 KSS、活动范围、并发症和生存率评估结果。平均随访时间为 9 年。
关节镜组的平均 KSS 从 36 分增至 84 分,对照组从 35 分增至 86 分(P=.5)。两组的术前和术后活动范围无差异(P=.2)。两组 5 年时无并发症生存率相似(关节镜组 94.3%,对照组 95.3%;P=.7),对照组有 2 例感染,关节镜组有 3 例(P=.2)。两组 10 年时无无菌性松动、任何原因翻修和再手术的生存率相似(关节镜组分别为 96.5%、94.6%和 89.2%,对照组为 96.2%、95.9%和 91.5%)。
两组间无显著差异。这些数据在 TKA 候选者中有许多曾行膝关节镜手术的时代令人安心且具有参考价值。