SynthesisBMC musculoskeletal disorders2025
Previous knee surgery increases risks of revision, infection, pain and stiffness after knee replacement arthroplasty: a systematic review and meta-analysis.
Synthesis in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Long-term survivorship after medial unicompartmental knee arthroplasty: the influence of medical comorbidities and previous knee surgery.International orthopaedics · 2026Article
- Chronic Pain and Stiffness After Total Knee Arthroplasty: A Comprehensive, Phenotype-Based Review of Mechanisms, Diagnosis and Management.Journal of clinical medicine · 2026Review
- Challenges and Strategies in Hydrogel-Based Cartilage Regeneration.Gels (Basel, Switzerland) · 2026Review
- Evaluation of a large language model for clinician-facing preoperative cost-communication preparation in total knee arthroplasty.Frontiers in medicine · 2026Article
- Postoperative inflammatory markers are not associated with hidden blood loss after knee arthroscopy.Frontiers in medicine · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundKnee replacement arthroplasty(KRA), including Total knee arthroplasty (TKA) and Unicompartmental knee arthroplasty (UKA), is the primary method for treating end-stage knee osteoarthritis (KOA). However, a history of previous knee surgeries (such as knee arthroscopy, ligament reconstruction, meniscectomy, high tibial osteotomy, etc.) may potentially affect functional recovery and complication risks after knee replacement. Although some studies have proposed such associations, the existing evidence remains controversial, and there is a lack of systematic quantitative analysis. This study aims to assess the impact of previous knee surgery on functional outcomes and complications following KRA.
methodsFollowing the PRISMA Guidelines, a systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases up to August 4, 2024, for relevant studies. Demographic data, postoperative complications, and functional changes after primary KRA were evaluated in patients with and without a history of previous knee surgery. Statistical analysis of the included studies was performed using Stata 15.1 software. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies.
resultsThis meta-analysis included 28 studies with 703,103 patients (35,535 with a history of previous knee surgery and 667,568 primary KRA patients). Compared to the primary knee surgery group, the previous knee surgery group had significantly higher rates of prosthetic aseptic revision (RR(95%CI) = 1.45 (1.18-1.78)) (relative risk, RR; Confidence Interval, CI), infection (RR(95%CI) = 1.36 (1.11-1.67)), knee stiffness (RR(95%CI) = 1.73 (1.02-2.96)), and knee pain (RR(95%CI) = 1.21 (1.08-1.34)). However, there were no significant differences in changes in Knee Society Score (KSS) function (WMD(95%CI) = -0.51 (-1.73 to 0.72)) (weighted mean difference, WMD), KSS pain score (WMD(95%CI) = 0.41 (-2.97 to 3.79)), or other knee function scores.
conclusionPatients with a history of previous knee surgery have a higher likelihood of prosthetic revision, a greater risk of surgical site infections or periprosthetic infections, and a significantly higher incidence of knee stiffness and knee pain following KRA.
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