Ashok Rajgopal1, Taufiq R Panjwani2, Arun Rao3, Vivek Dahiya1. 1. Fortis Bone and Joint Institute, New Delhi, India. 2. Adult Reconstruction and Sports Medicine, Fortis Bone and Joint Institute, New Delhi, India. 3. Department of Physiotherapy, Fortis Bone and Joint Institute, New Delhi, India.
Abstract
BACKGROUND: Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies. METHODS: We retrospectively reviewed records of 228 consecutive cases of revision TKA from 2008 to 2014. Revisions performed for aseptic loosening (n = 53), septic revisions (n = 48), and isolated flexion instability (n = 45) with a minimum of 18 months follow-up were included for analysis. Revision for all other etiologies (n = 82) were excluded. The Modified Knee Society Score (KSS), KSS Function, and Western Ontario and McMaster Universities Osteoarthritis Index were recorded for all cases. A 7-point Likert scale was used to record patient's perception of outcomes after revision surgery and analyzed based on etiology. RESULTS: Although all groups showed improvement in outcome after revision TKA, the changes in Modified KSS and KSS-Function varied according to the etiology of failure of the primary procedure with the smallest improvement being reported by the flexion instability group. CONCLUSION: Patients undergoing revision for isolated flexion instability have less improvement in functional outcome as compared with other etiologies. We hypothesize this is due to a higher baseline preoperative knee function in the flexion instability group.
BACKGROUND: Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies. METHODS: We retrospectively reviewed records of 228 consecutive cases of revision TKA from 2008 to 2014. Revisions performed for aseptic loosening (n = 53), septic revisions (n = 48), and isolated flexion instability (n = 45) with a minimum of 18 months follow-up were included for analysis. Revision for all other etiologies (n = 82) were excluded. The Modified Knee Society Score (KSS), KSS Function, and Western Ontario and McMaster Universities Osteoarthritis Index were recorded for all cases. A 7-point Likert scale was used to record patient's perception of outcomes after revision surgery and analyzed based on etiology. RESULTS: Although all groups showed improvement in outcome after revision TKA, the changes in Modified KSS and KSS-Function varied according to the etiology of failure of the primary procedure with the smallest improvement being reported by the flexion instability group. CONCLUSION:Patients undergoing revision for isolated flexion instability have less improvement in functional outcome as compared with other etiologies. We hypothesize this is due to a higher baseline preoperative knee function in the flexion instability group.
Authors: Simon C Mears; A Cecilia Severin; Junsig Wang; Jeff D Thostenson; Erin M Mannen; Jeffrey B Stambough; Paul K Edwards; C Lowry Barnes Journal: J Arthroplasty Date: 2022-03-17 Impact factor: 4.435
Authors: Shiraz A Sabah; Elizabeth A Hedge; Simon G F Abram; Abtin Alvand; Andrew J Price; Sally Hopewell Journal: BMJ Open Date: 2021-10-21 Impact factor: 2.692