Abstract
BACKGROUND: Arthroscopic meniscectomy (AM) is a common procedure in middle-aged adults with degenerative meniscal tears. As many of these patients eventually require total knee arthroplasty (TKA), concerns have emerged regarding the potential impact of prior AM on TKA outcomes. This study evaluated whether a history of ipsilateral AM is associated with increased short- and mid-term complications following TKA. METHODS: Using the PearlDiver national database, adult patients who underwent primary TKA for osteoarthritis between 2016 and 2022 with 1-year of follow-up and laterality available were identified (n = 1,152,444). Patients with prior ipsilateral AM were matched 1:1 to controls without prior AM based on age, sex, comorbidities, and year of surgery (n = 40,341 per group). Multivariate logistic regression was used to evaluate 90-day healthcare utilization (emergency department visits, reoperations, and readmissions) and 1- and 2-year revision risks (all-cause, septic, and aseptic). RESULTS: Approximately 3.5 % of TKA patients had prior AM. Patients with prior AM had significantly higher rates of 90-day emergency department visits (OR, 1.23; 95 % CI, 1.18-1.29), reoperations (OR, 2.10; 95 % CI, 1.95-2.27), and readmissions (OR, 1.43; 95 % CI, 1.32-1.55) (all p < 0.001). At 1-year post-TKA, these patients had increased odds of all-cause revision (OR, 2.47), revision for PJI (OR, 2.15), and aseptic revision (OR, 2.62). These risks remained elevated at 2 years: all-cause revision (OR, 2.83), revision for PJI (OR, 2.33), and aseptic revision (OR, 3.06) (all p < 0.001). CONCLUSIONS: Prior ipsilateral AM is associated with significantly increased risks of short- and mid-term complications following primary TKA, including reoperations, readmissions, and both septic and aseptic revisions. These findings highlight the need for careful patient counseling and surgical planning in patients with a history of meniscectomy. LEVEL OF EVIDENCE: Level III; Retrospective cohort study.