Abstract
Background: Total knee arthroplasty (TKA) after prior anterior cruciate ligament reconstruction (ACLR) presents unique technical challenges. The purpose of this study was to compare patient-reported outcomes (PROs) between patients undergoing TKA after prior ACLR and matched controls without prior ACLR.
Methods: We retrospectively analyzed patients who underwent primary TKA between 2018 and 2023 at a high-volume orthopaedic center. Patients with prior ipsilateral ACLR were matched 1:2 to controls by age, sex, BMI, and ASA score. PROs including KOOS Jr. and PROMIS Physical Function were collected using the Force Therapeutics digital platform preoperatively and at 6 weeks, 3 months, and 12 months postoperatively.
Results: Sixty-two ACLR patients were matched to 124 controls. Both groups demonstrated significant improvement in PROs from baseline. ACLR patients had lower KOOS Jr. scores at 6 weeks (p=0.04) and 3 months (p=0.03) but equivalent scores at 12 months. Complication rates and patient satisfaction were equivalent between groups.
Conclusion: TKA after prior ACLR results in equivalent 12-month PROs compared to matched controls, though early recovery may be slower. Patients should be counseled regarding potential for delayed early recovery.