Abstract
The incidence of anterior cruciate ligament (ACL) reconstruction is increasing in
the United States, particularly in the older athlete. Patients who undergo ACL reconstruction
are at higher risk for undergoing total knee arthroplasty (TKA) later in life. TKA
in patients with prior ACL reconstruction has been associated with longer operative
time due in-part to difficulty with exposure and retained hardware. Outcomes after
TKA in patients with prior ACL reconstruction are not well defined, with some reports
showing increased rate of complications and higher risk of reoperation compared with
routine primary TKA, but these results are based on small and nonrandomized cohorts.
Future research is needed to determine whether graft choice or fixation technique
for ACL reconstruction influences outcomes after subsequent TKA. Furthermore, whether
outcomes are affected by choice of TKA implant design for patients with prior ACL
reconstruction warrants further study. This review analyzes the epidemiology, operative
considerations, and outcomes of TKA following ACL reconstruction.
Keywords
anterior cruciate ligament reconstruction - total knee arthroplasty - osteoarthritis
