• History of knee dislocation is...

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

Title:
History of knee dislocation is associated with longer operative times and higher constraint in total knee arthroplasty: a matched cohort analysis.
Authors:
Albertson B; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Kurnik C; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Curtis W; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA. Electronic address: wjcurtis1@gmail.com., O'Hora J; Department of Emergency Medicine, MetroHealth, Cleveland OH, USA., Ludwig T; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Shultz C; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Schenck RC; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Treme G; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Richter DL; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA., Decker M; Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee WI, USA., Wascher DC; Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA.
Source:
The Knee [Knee] 2025 Dec; Vol. 57, pp. 12-18. Date of Electronic Publication: 2025 Aug 12.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9430798 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-5800 (Electronic) Linking ISSN: 09680160 NLM ISO Abbreviation: Knee Subsets: MEDLINE
Imprint Name(s):
Publication: [s.l.] : Elsevier
Original Publication: Oxford, UK : Butterworth-Heinemann, c1994-
MeSH Terms:
Arthroplasty, Replacement, Knee*/methods , Operative Time* , Osteoarthritis, Knee*/surgery , Knee Dislocation*/complications , Knee Dislocation*/surgery, Humans ; Male ; Female ; Retrospective Studies ; Aged ; Middle Aged ; Postoperative Complications/epidemiology ; Range of Motion, Articular ; Reoperation
Contributed Indexing:
Keywords: Knee dislocation; Multi-ligament knee injury; Total knee arthroplasty
Entry Date(s):
Date Created: 20250813 Date Completed: 20251128 Latest Revision: 20251128
Update Code:
20251129
DOI:
10.1016/j.knee.2025.07.015
PMID:
40803096
Database:
MEDLINE

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Background: 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.
Methods: 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.
Results: 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.
(Copyright © 2025 Elsevier B.V. All rights reserved.)

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: “Christopher Shultz, MD receives educational support from Arthrex, Inc and Desert Mountain Medical. Gehron Treme, MD receives educational support from Arthrex, Inc and Desert Mountain Medical. Dustin L. Richter, MD receives fellowship support from Arthrex and Stryker, serves on the editorial board for Video Journal of Sports Medicine and on the education committee of AOSSM. Daniel C. Wascher, MD serves as the deputy editor for the American Journal of Sports Medicine and associate editor for the Orthopaedic Journal of Sports Medicine.”.