Patients Who Have Undergone Non-Arthroplasty Operative Procedures Are at Higher Risk to Require Total Knee Arthroplasty: Commentary on the article by Robert H. Brophy, MD, et al.: “Total Knee Arthroplasty After Previous Knee Surgery: Expected Interval and

Just as the entire field of medicine has witnessed a major evolution in the past several decades, so has orthopaedic surgery. Concomitant with this increase of knowledge has been an increased sophistication on the part of our patients. An increasing number of individuals participate in sporting activities in early childhood, leading to an increase in the number of weekend warriors during adolescence and early adulthood. This has led to an increasing number of injuries and the resulting need for orthopaedic intervention.

As noted by Brophy et al., more than 650,000 knee arthroscopies and 175,000 anterior cruciate ligament reconstructions are performed annually in the United States. The long-term outcome of these procedures has received little attention. It is essentially unknown whether these patients will be at an equal or increased risk for developing further disease in their knee and ultimately require total knee arthroplasty. The purpose of this study was to attempt to address this specific question.

Brophy and colleagues determined the prevalence of previous knee surgery in patients undergoing total knee arthroplasty and attempted to determine the interval from the previous surgery to the ultimate total knee arthroplasty. The authors also wished to assess the age at which the patients who had previous knee surgery presented for total knee arthroplasty. Brophy and colleagues questioned if these patients were actually younger than the overall patient population presenting for total knee arthroplasty.