The Knee, ISSN: 1873-5800, Vol: 22, Issue: 6, Page: 630-9

Outcomes after Total Knee Arthroplasty for post-traumatic arthritis

Abiram Bala; Colin T. Penrose; Thorsten M. Seyler; Richard C. Mather III; Samuel S. Wellman; Michael P. Bolognesi
Knee

Highlights

  • We examined complications of Total Knee Arthroplasty (TKA) for posttraumatic arthritis (PTA) versus primary osteoarthritis.
  • We found similar predicted 10-year survival for each group.
  • Patients who have PTA for TKA have fewer immediate postoperative medical complications.
  • Patients who have PTA for TKA have higher postoperative infection-related surgical complications.
  • Patients who have PTA for TKA have higher overall reoperation rates.

Abstract

Introduction

Total Knee Arthroplasty (TKA) is an important treatment for posttraumatic arthritis (PTA), but evidence on outcomes is sparse. The purpose of this study was to evaluate the impact of PTA versus primary osteoarthritis (OA) on postoperative outcomes after TKA.

Methods

We queried the entire Medicare database from 2005 to 2012. International Classification of Diseases, 9th revision and Current Procedural Terminology codes were used to identify the procedure, indication, and complications. Patients with minimum two-years follow-up were selected. Odds ratios (ORs), confidence intervals, and p-values (p) were calculated.

Results

For PTA, 3509 patients had TKA. For OA, 257,611 patients with TKA served as controls. The average Charlson Comorbidity Index for both groups was five. PTA patients were younger; only eight out of 29 Elixhauser comorbidities were higher. PTA patients had higher incidence of periprosthetic infection (OR 1.72, p < 0.001), cellulitis or seroma (OR 1.19, p < 0.001), knee wound complications (OR 1.80, p < 0.001), TKA revision (OR 1.23, p = 0.01), and arthrotomy/incision and drainage (OR 1.55, p < 0.001). Blood transfusion rate was lower in PTA patients. There were no significant differences in bleeding complications, prosthetic dislocation, broken prostheses, periprosthetic fracture, osteolysis and polywear, neurovascular injury, and extensor mechanism rupture.

Discussion and conclusion

This study represents, to our knowledge, TKA outcomes in the largest cohort of PTA patients to date. Our findings indicate that these patients are at higher risk for many, but not all, postoperative surgical complications despite being as healthy as patients receiving TKA for primary OA.


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