The Impact Of Knee Athroscopy On Srubsequent Total Knee Athroplasty:Meta-Analysis

Objective:To evaluate the impact of knee arthroscopic surgery on the prognosis of subsequent total knee arthroplasty(Total Knee Arthroplasty,TKA)by Meta-analysis.Methods:From the time of building databases to October 2020,Literatures on the impact of knee arthroscopy on the prognosis of subsequent TKA were searched from PubMed,EMbase,Cochrane Library,CNKI,Wanfang,Vip and other databases.According to the criteria for inclusion and exclusion,screening of the literature,quality evaluation and data extraction were carried out,and the NOS scale was used to evaluate the literature quality of non-randomized controlled studies.Using Review Manager 5.3 software,Meta-analysis was performed on the revision rate,reoperation rate,postoperative stiffness rate,periprosthetic infection rate,postoperative venous thrombosis(Venous thromboembolism,VTE)rate and postoperative knee flexion range of motion after TKA.Results:8 articles were finally included,with a total sample size of 182,81 5 cases.Among them,6998 cases were in the knee arthroscopy group and 175,817 cases were in the knee arthroscopy group.Meta-analysis results showed that:compared with the knee arthroscopic surgery group,the revision rate after TKA[OR=1.66,95%Cl(1.37,2.00),P<0.00001]and the reoperation rate[OR=2.31,95%CI(1.59,3.36),P<0.0001],postoperative stiffness rate[OR=1.78,95%Cl(1.02,3.11),P=0.04]and infection rate around the prosthesis[OR=1.40,95%Cl(1.19,1.66),P<0.0001],the difference was statistically significant.The knee arthroscopic surgery group had a higher rate of revision,reoperation,postoperative stiffness,and infection around the prosthesis.The incidence of postoperative VTE[OR=1.06,95%Cl(0.83,1.35),P=0.64]and postoperative knee flexion range of motion[MD=-1.21,95%Cl(-3.07,0.65),P=0.20].There was no statistically significant difference between the two groups(P>0.05).Conclusion:Knee arthroscopy has a negative impact on subsequent TKA surgery.Previous arthroscopic treatment increased the risk of stiffness,periprosthetic joint infection,revision and reoperation after TKA,but there was no significant difference in the postoperative knee flexion range of motion and the incidence of VTE.