Prior unilateral total hip arthroplasty does not influence the outcome of ipsilateral total knee arthroplasty

Abstract

Purpose To assess the influence of a prior well-functioning unilateral primary total hip arthroplasty (THA) on the functional outcome of a subsequent ipsilateral primary total knee arthroplasty (TKA). Methods A retrospective case–control study of 92 patients older than 60 years underwent unilateral primary TKA after a prior ipsilateral THA (THA-TKA group) and 92 matched patients underwent only TKA (TKA group). Clinical assessments were performed using the Knee Society Scores (KSS) and Harris Hip Score (HSS), quality of life by the Reduced Western Ontario and MacMaster Universities (WOMAC) and Short-Form 12 (SF-12) questionnaires. Radiological evaluation was also performed. Results Median follow-up after TKA was 7.2 (range 5–9) years. There were no significant differences between groups in baseline data at the TKA time. The mean gains in KSS were similar in both groups. At the last follow-up, there were no significant differences in WOMAC-pain or SF12-physical scores, but the WOMAC-function (p = 0.003) and SF12-mental (p = 0.018) scores were significantly better in the isolated TKA group. At the last follow-up, there were no significant differences in the radiological knee alignment or component positions. For aseptic reasons, the TKA survival at 8 years in the TKA group was 95.8 (95% CI 87.8–100%), and 96.6% (95% CI 91.8–100%) in the THA-TKA group (ns). Conclusion A well-functioning unilateral THA does not influence on the functional outcome of a subsequent ipsilateral TKA. This finding can help clinicians when counseling patients with hip and knee osteoarthritis. Level of evidence III.