Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice

Abstract

Purpose: To compare the rate of previous knee arthroscopy in patients undergoing total knee arthroplasty (TKA) before (2005-2006) and after (2018) publication of landmark studies that examined the effectiveness of knee arthroscopy as well as the American Academy of Orthopaedic Surgeons 2013 knee arthroscopy guidelines.

Methods: We performed a retrospective chart review of 214 patients who underwent a TKA between 2005 and 2006 (Group 1) and 213 patients who underwent a TKA in 2018 (Group 2). We reviewed medical records to determine whether previous knee arthroscopy was performed. Group comparisons were made using the t test for continuous data and the χ² test for categorical data, and means ± standard deviation are presented.

Results: Patients in Group 2 were older than those in Group 1 (67.0 ± 8.3 vs 64.3 ± 11.5 years, P = .01); however, there were no differences between groups with respect to sex (P = .40), body mass index (P = .36), and laterality of TKA (P = .05). There was no difference in the history of previous knee arthroscopy between Groups 1 and 2 overall (27% vs 32%, P = .27) and within 10 years of TKA (17% vs 15%, P = .44).

Conclusions: We did not find a difference in the number of previous knee arthroscopies for patients undergoing TKA in 2018 versus 2005-2006. This suggests that the recommendations set forth by landmark clinical trials that examined the effectiveness of knee arthroscopy and the AAOS 2013 knee arthroscopy guidelines did not have a sudden impact within our geographic region, but there is some evidence to suggest a gradual shift in treatment, where knee arthroscopy is withheld near imminent knee arthroplasty.

Level of evidence: III, retrospective comparative study.

Fig 1

Number of knee arthroscopies before total knee arthroplasty (TKA) by group. ∗2013 AAOS knee arthroscopy guidelines. Data are not mutually exclusive, since some patients had multiple knee arthroscopies.

Fig 2

(A) Number of knee arthroscopies before total knee arthroplasty (TKA) within 10 years of TKA for Group 1 (TKA 2005-2006). Data are not mutually exclusive (41 knee arthroscopies in 37 patients). (B) Number of knee arthroscopies before total knee arthroplasty (TKA) within 10 years of TKA for Group 2 (TKA 2018). Data are not mutually exclusive (32 knee arthroscopies in 31 patients).