To date, various studies exploring the effects of previous knee surgery on subsequent total knee arthroplasty (TKA) have been published in the orthopaedic literature.5,9,18,19,22,24 In particular, there has been a growing interest in the effects of prior ligamentous knee surgery on subsequent TKA outcomes. Anterior cruciate ligament (ACL) tears are a common orthopaedic injury, with an estimated annual incidence of 68.6 per 100,000 person-years in the United States.20 ACL reconstruction (ACLR) is the treatment of choice in patients with ACL ruptures who are candidates for operative management, and over 100,000 ACLRs are performed annually in the United States alone.4 However, there is evidence indicating that ACL injury and surgery may accelerate osteoarthritis in both the patellofemoral and tibiofemoral joints, particularly when associated with meniscal damage.7,17
Although ACLR produces favorable results in many patients, subsequent degenerative changes may arise from failure to fully restore the normal kinematics of the knee joint, chondral damage from the initial trauma and pivot shift, or concomitant meniscal tears. Degenerative changes in the knee have been reported as early as 1 to 2 years following ACL injury regardless of whether patients had undergone ACLR or nonoperative management for their initial injury.6,21 Thus, patients with a history of ACLR are at increased risk of undergoing ipsilateral TKA for the treatment of advanced knee osteoarthritis. Leroux et al12 reported that the cumulative incidence of TKA among patients with a history of ACLR was 7 times greater at 15-year follow-up than in matched controls without a history of ACLR. In addition, Brophy et al3 reported that patients with a history of knee surgery, especially those who have previously undergone knee ligament reconstruction, undergo ipsilateral TKA at a significantly younger age than patients without a history of knee surgery.
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Because patients with a history of ACLR undergo TKA at a higher rate than patients without a history of ACLR, it is important to elucidate whether ACLR affects the outcome of subsequent TKA. The purpose of this study was to compare clinical outcomes of TKA in patients with and without a history of ACLR through a systematic review. We hypothesized that prior ACLR would lead to inferior clinical outcomes in patients undergoing subsequent TKA.
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