Yılmaz ÖNDER, Tolgacan KURTULUŞ, Mahmut TUNÇEZ, Tuğrul BULUT
Forbes Tıp Dergisi - 2026;7(1):7-14
Introduction: The aim of this study is to investigate the relationship between preoperative Kellgren-Lawrence (KL) grade and hospital length of stay and early postoperative complications in patients undergoing primary total knee arthroplasty (TKA). Methods: Patients who underwent cemented posterior-stabilized TKA between January 2023 and January 2026 were retrospectively evaluated. Patients aged >=55 years with a diagnosis of primary knee osteoarthritis (OA), preoperative weight-bearing knee plain radiographs, and at least 6 months of follow-up were included in the study. Valgus deformity, KL grade 2, body mass index (BMI) >=35, inflammatory arthritis, post-traumatic arthritis, revision surgery, and patients without adequate follow-up or suitable plain radiographs were excluded. Patients were grouped according to their KL grades. All demographic variables, in addition to hospital length of stay and early minor and major complications, were statistically evaluated. Statistical significance was defined as a p value <0.05 for all analyses. Results: A total of 482 patients were included in the study (KL grade 3: n=254, 52.7%; KL grade 4: n=228, 47.3%). There were no significant differences between the groups in terms of age, BMI, surgical time, American Society of Anesthesiologists score, Charlson comorbidity index, and blood transfusion requirement (for each p>0.05). Hospital length of stay was significantly longer in the KL grade 4 group (p=0.004). The rate of major complications was higher in the KL grade 4 group (p=0.031), while the rates of minor complications were similar (p>0.05). Conclusion: Increased preoperative radiographic OA severity is associated with longer hospital length of stay and a higher rate of major complications after primary TKA.
