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J Knee Surg 2022; 35(04): 375-383
DOI: 10.1055/s-0040-1715447
Original Article

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

Han-Jun Lee‡   ∗
1   Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, South Korea
,
Seong Hwan Kim  ‡   ∗
2   Department of Orthopedic Surgery, Hyundae General Hospital, Chung-Ang University College of Medicine, Namyangju-si, Gyeonggi-do, South Korea
,
Nicolas Pujol 
3   Department of Orthopedic, Centre Hospitalier de Versailles, Le Chesnay, France
,
Yong-Beom Park 
1   Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, South Korea
› Author Affiliations Funding This research was supported by the Chung-Ang University Research Grants in 2019.
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Abstract

The purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 1:3 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scores, and patients' satisfaction including perception of LLD were evaluated. Radiographic evaluation included mechanical axis, component position, and LLD. Logistic regression analysis was performed to find the factors that affect the clinical outcomes. No significant differences in radiologic and clinical evaluations, except for KS function score, patient's satisfaction and LLD (p< 0.001), were detected between the groups. LLD and its perception were significantly higher in group 2 (1.8 ± 3.4 mm in group 1 and 9.7 ± 4.1 mm in group 2, p = 0.000). Risk factors for the low KS function score were found as LLD (odds ratio [OR]: 1.403, p = 0.008) and previous hip arthroplasty itself (OR: 15.755, p = 0.002), but much higher OR was found in previous hip arthroplasty. Although the outcomes of TKA in patients with ipsilateral hip arthroplasty are comparable to those of primary TKA, LLD was high and patient's satisfaction and functional outcomes were low in patients with previous ipsilateral hip arthroplasty. Care should be taken when considering TKA in patients with previous hip arthroplasty. This is a Level III, case control study.

Keywords

total knee arthroplasty - hip arthroplasty - ipsilateral - clinical outcomes - leg length discrepancy

Ethical Approval

The study was approved by the Institutional Review Boards of Chung-Ang University Hospital (No.:1601–009–255) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.


∗ These two authors contributed equally to this work.




Publication History

Received: 13 December 2019

Accepted: 25 June 2020

Article published online:
24 August 2020

© 2020. Thieme. All rights reserved.

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