History of knee dislocation is associated with longer operative times and higher constraint in total knee arthroplasty: a matched cohort analysis.

Abstract

Knee dislocations (KD) are devastating injuries that are known to predispose to post-traumatic arthritis of the knee. While some patients will require total knee arthroplasty (TKA), there is limited literature on outcomes of TKA following KD. The purpose of this study is to compare surgical characteristics and outcomes between patients undergoing TKA following KD versus those undergoing TKA for osteoarthritis. A retrospective review was conducted of patients who underwent TKA after KD between 2006 and 2021. The KD cohort was matched 1:2 to a cohort of primary TKA patients with a preoperative diagnosis of arthritis based on sex, age, and surgery date. Surgical variables included TKA constraint level, operative time, and tourniquet time. Postoperative complications including infection, instability, stiffness, and revision surgery were also recorded. Fifteen patients were identified who underwent TKA following KD with a mean follow-up of 2.8 years. The KD cohort had longer tourniquet times (117 ± 34.5 vs. 84.9 ± 23.9 min, p < 0.01) and operative times (180.7 ± 55.9 vs 121.6 ± 25.3 min, p < 0.001). The KD group more often required higher levels of constraint and stem usage (p < 0.0001). KD patients trended toward higher rate of infection (20 % vs 0 %, p = 0.03), and revision surgery (26 % vs 3 %, p = 0.04). No statistically significant difference was found in postoperative range of motion at final follow-up up (118° [85-135°] vs. 116° [90-140°]; p = 0.8) CONCLUSION: TKA after KD is associated with longer operative times and increased use of constrained and stemmed implants.