Ioannis Syrikas
NU-Hospital Group, SwedenPresentation Title:
The impact of prior anterior cruciate ligament reconstruction on patient reported outcome measures of patients undergoing subsequent total knee arthroplasty. A Swedish registry-based study
Abstract
Background
Patients with a history of anterior cruciate ligament reconstruction (ACLR) face an increased risk of developing post-traumatic osteoarthritis, often necessitating total knee arthroplasty (TKA). However, the impact of prior ACLR on patient-reported outcomes (PROs) following TKA remains unclear. This study compared PROs in TKA patients with prior ACLR to those without prior ACLR.
Methods
This observational study utilized data from the Swedish Arthroplasty and Knee Ligament Registers. A total of 3,454 TKA patients with prior ACLR (ACLROA) were matched 1:2 with TKA patients without prior knee surgery (OA) by age, sex, BMI, ASA score, implant type, and surgery year. Patient-reported outcome measures (PROMs) assessed included KOOS-12, EQ-5D-3L, pain Likert scale and satisfaction Likert scale, collected preoperatively and at one year postoperatively.
Results
The ACLROA group reported statistically significantly lower satisfaction one year postoperatively, with 54.0% being "very satisfied" compared to 60.8% in the OA group (p=0.002). Pain was similar between the two groups, with no significant differences in pain severity postoperatively (p=0.166). The OA group achieved higher KOOS-12 scores postoperatively across all subscales, including pain (72.99 vs. 65.76, p<0.001), function (66.31 vs. 61.16, p<0.001), and quality of life (59.40 vs. 51.80, p<0.001). Similarly, EQ-5D-3L utility and VAS health scores were statistically significantly higher in the OA group postoperatively (utility: 0.90 vs. 0.88, p=0.009; VAS: 80.34 vs. 78.13, p=0.027). Gains in utility (0.14 vs. 0.11, p=0.002) and VAS health (14.64 vs. 12.26, p=0.048) were also statistically significantly greater in the OA group.
Conclusion
Both groups improved in PROs after TKA. However, prior ACLR patients had less favorable postoperative outcomes compared to OA group. These findings emphasize the importance of preoperative counseling for patients with a history of ACLR, addressing the potential for less optimal results, while highlighting the benefits of TKA in improving function and quality of life.
Biography
Ioannis Syrikas, MD, MSc, is a PhD candidate at the
University of Gothenburg, affiliated with the Institute of Clinical Sciences at
the Sahlgrenska Academy, specializing in orthopaedics. He concurrently serves
as a consultant orthopaedic surgeon at the Department of Orthopaedics,
NU-Hospital Group, Trollhättan/Uddevalla, Sweden. With a robust background in
clinical practice and research, his work focuses on the outcomes of total knee
arthroplasty (TKA), particularly in complex cases involving post-traumatic
osteoarthritis (PTOA). His research has led to the publication of a systematic
review analyzing increased complication rates and inferior patient-reported
outcomes for TKA in patients with PTOA compared to those with primary
osteoarthritis. His academic endeavors also extend to national registry-based
studies linking datasets such as the Swedish Arthroplasty Register, the Swedish
Fracture Register, and the Swedish Knee Ligament Register to evaluate surgical
outcomes and patient-reported measures.
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