The Journal of arthroplasty · 2024
Undergoing Meniscectomy Within One Year Before Primary Total Knee Arthroplasty Is Associated With Worse Postoperative Outcomes.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Khan Irfan A, DeSimone Cristian A, Vaile John R, Sonnier John Hayden, Sherman Matthew B, Mazur Donald W, Freedman Kevin B, Fillingham Yale A
Аннотация
BACKGROUND: Patients undergoing primary total knee arthroplasty (TKA) who have a history of meniscectomy have worse postoperative functional outcomes, increased rates of early postoperative complications, and higher revision rates. Despite knowing this, to the best of our knowledge, it has not been previously studied whether the timing of meniscectomy before TKA impacts functional outcomes after undergoing TKA. Compared to patients who underwent meniscectomy more than one year before TKA, do patients who have meniscectomy less than one year before TKA have significantly different postoperative outcomes?
METHODS: A retrospective cohort study was conducted at an academic medical center. Patients who did not have a history of meniscectomy (controls) were matched in a 1:3 ratio with patients who underwent meniscectomy before primary TKA (cases) based on age, sex, race, body mass index, and nonage-adjusted Charlson Comorbidity Index. The inclusion criteria consisted of patients undergoing TKA from 2013 to 2020, with a minimum of one-year follow-up for Knee Injury and Osteoarthritis Outcome Score Joint Replacement (KOOS-JR). The exclusion criteria comprised patients undergoing revision or conversion TKA. There were 1,767 patients in the control cohort and 589 patients in the cases cohort who were included.
RESULTS: Preoperative KOOS-JR scores did not significantly differ between the five cohorts, while postoperative KOOS-JR scores were significantly lower for patients who underwent meniscectomy less than six months before TKA and between six months and 1 year before TKA. Patients undergoing meniscectomy within six months of TKA had a significantly higher rate of aseptic revision, while patients who had a history of meniscectomy at other timeframes did not have a significantly increased rate of aseptic revision.
CONCLUSIONS: Patients undergoing TKA who had a history of meniscectomy within 1 year of the TKA may experience worse postoperative functional outcomes, and patients undergoing meniscectomy within six months of TKA may have an increased risk of revision TKA.
METHODS: A retrospective cohort study was conducted at an academic medical center. Patients who did not have a history of meniscectomy (controls) were matched in a 1:3 ratio with patients who underwent meniscectomy before primary TKA (cases) based on age, sex, race, body mass index, and nonage-adjusted Charlson Comorbidity Index. The inclusion criteria consisted of patients undergoing TKA from 2013 to 2020, with a minimum of one-year follow-up for Knee Injury and Osteoarthritis Outcome Score Joint Replacement (KOOS-JR). The exclusion criteria comprised patients undergoing revision or conversion TKA. There were 1,767 patients in the control cohort and 589 patients in the cases cohort who were included.
RESULTS: Preoperative KOOS-JR scores did not significantly differ between the five cohorts, while postoperative KOOS-JR scores were significantly lower for patients who underwent meniscectomy less than six months before TKA and between six months and 1 year before TKA. Patients undergoing meniscectomy within six months of TKA had a significantly higher rate of aseptic revision, while patients who had a history of meniscectomy at other timeframes did not have a significantly increased rate of aseptic revision.
CONCLUSIONS: Patients undergoing TKA who had a history of meniscectomy within 1 year of the TKA may experience worse postoperative functional outcomes, and patients undergoing meniscectomy within six months of TKA may have an increased risk of revision TKA.