PRIOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION EFFECTS ON FUTURE TOTAL KNEE ARTHROPLASTY: A RETROSPECTIVE COHORT STUDY

Nilesh Kumar  Agrawal; Anant  Akash; Kumar  Rahul; Santosh  Kumar

doi:10.51168/sjhrafrica.v5i12.1500

Authors

Nilesh Kumar Agrawal Senior Resident, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Anant Akash Senior Resident, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India. https://orcid.org/
Kumar Rahul Senior Resident, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Santosh Kumar Professor and Head, Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1500

Keywords:

Total Knee Arthroplasty, ACL Reconstruction, Hardware Removal, Operative Time, Complication Rates

Abstract

Background

Total knee arthroplasty (TKA) in patients with preexisting anterior cruciate ligament (ACL) reconstruction hardware poses unique surgical challenges. The need for hardware removal and complex exposure techniques distinguishes these cases from routine TKA. This study aimed to compare intraoperative parameters, such as operative time and estimated blood loss in patients undergoing TKA with prior ACL reconstruction hardware to a matched control group of primary osteoarthritis patients with no history of ligament reconstruction.

Methods

This retrospective matched cohort study included 25 patients undergoing primary total knee arthroplasty (TKA) with prior anterior cruciate ligament (ACL) reconstruction hardware at IGIMS, Patna. Participants were divided into an ACL group and a matched control group without prior ACL reconstruction. Data on demographics, surgical parameters, estimated blood loss, and postoperative complications were collected and analyzed.

Results

The study included 10 patients in the ACL group and 15 in the control group. Operative time was longer in the ACL group (8–16 minutes), though differences in estimated blood loss (EBL) were not statistically significant. Postoperative complication rates were low and comparable between groups. Hardware removal was necessary in 82% of ACL group cases due to modern fixation techniques impeding safe instrumentation.

Conclusion

TKA in patients with prior ACL reconstruction requires meticulous preoperative planning to address extended operative times and surgical exposure challenges while achieving outcomes comparable to routine TKA.

Recommendation

Surgical intervention should be postponed until post-injury knee effusion has subsided, full knee range of motion has been restored, and professional considerations indicate that the patient is physically ready for surgery.

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