Knee Arthroscopy After Total Knee Arthroplasty: Not a Benign Procedure

J Arthroplasty. 2020 Dec;35(12):3575-3580. doi: 10.1016/j.arth.2020.06.082. Epub 2020 Jul 2.

Abstract

Background: Outcomes of knee arthroscopy (KA) after total knee arthroplasty (TKA) have been limited to small case series with short-term follow-up. The purpose of this study is to report the outcomes of patients who undergo a KA after a TKA using a large longitudinal database.

Methods: The PearlDiver Medicare database was queried for patients who underwent a KA procedure after a TKA on the ipsilateral extremity. A randomly selected control group was created by matching controls to cases in a 3:1 ratio based on age, gender, year of procedure, and Elixhauser Comorbidity Index. Revision for infection and all-cause revision were used as end points.

Results: A total of192 TKA patients who underwent a subsequent KA (TKA + KA group) were compared to 571 TKA patients who did not have a subsequent KA (TKA - KA group). The incidence of revision for infection was 6.3% in the TKA + KA group compared to 2.2% in the TKA - KA group (odds ratio, 2.87; P = .009). The incidence of all-cause revision was 18.8% in the TKA + KA group compared to 5.1% in the TKA - KA group (odds ratio, 4.34; P < .001).

Conclusion: KA after TKA was associated with increased infection-related and all-cause revision. The association between KA and subsequent infection requires further investigation.

Keywords: complications; knee arthroscopy; periprosthetic joint infection; revision; total knee arthroplasty.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Arthroscopy
  • Humans
  • Knee Joint / surgery
  • Medicare
  • Odds Ratio
  • Reoperation
  • Retrospective Studies
  • United States