Document

Risk Factors for Subsequent Contralateral TKA after Primary TKA

Description

Abstract:

 

Background

This study examines the likelihood of subsequent contralateral total knee arthroplasty (TKA) within 3 years after unilateral TKA and associated factors. Patients with bilateral osteoarthritis may have symptoms on only one side, leading to consideration of bilateral TKA during one hospitalization, especially in areas with limited healthcare access. Some patients prefer bilateral TKA to address leg length and alignment concerns after unilateral TKA.

Methods

384 patients undergoing unilateral TKA were analyzed from 807 primary TKA cases (Dec 2013 - Aug 2019). Patient characteristics, including age, sex, BMI, K-L grade, and HKA angle of the contralateral knee, were assessed. Limb length discrepancy (LLD) after TKA was evaluated. Patients were followed up for 3 years, with various statistical methods used for analysis.

Results

Within 3 years, 10.9% (42 patients) needed contralateral TKA. Higher K-L grades, more varus HKA angles, and greater LLD in the contralateral knee were linked to a higher likelihood. K-L grade was the strongest predictor.

Conclusion

Around 11% of patients undergoing unilateral TKA required contralateral TKA within 3 years. Probability increased with severe varus deformity and higher K-L grades. However, performing TKA on the contralateral knee with mild symptoms and high K-L grade may not be advisable due to surgical burden.

 

Keywords:Total knee arthroplasty, knee osteoarthritis, elderly Koreans.

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Author

Chong Bum Chang

Chong Bum Chang

Professor, Orthopedics

Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea

ESSKA Continuous Professional Education Partners