The Effect of Preoperative Kellgren-Lawrence Grade on Length of Stay and Early Postoperative Complications After Primary Total Knee Arthroplasty

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.Material and Method: Patients who underwent cemented posterior-stabilized total knee arthroplasty between January 2023 and January 2026 were retrospectively evaluated.Patients aged ≥55 years with a diagnosis of primary knee osteoarthritis, preoperative weight-bearing knee plain radiographs, and at least 6 months of followup were included in the study.Valgus deformity, KL grade 2, 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 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 pvalue 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 osteoarthritis severity is associated with longer hospital length of stay and a higher rate of major complications after primary total knee arthroplasty.