Abstract
The etiology of failure following primary total knee arthroplasty (TKA) leading to
revision surgery are multifactorial, including infection, instability, loosening,
contracture, and wear. Although the majority of patients have successful outcomes
following revision TKA, postoperative complications are still increased in these patients
when compared to primary patients. For this reason, there has been a continued search
to identify options, including prosthesis types, to potentially improve outcomes.
Therefore, the purpose of this study was to determine if the clinical results achieved
following revision TKA are comparatively similar to primaries using the same implant
design. Specifically, we compared (1) Knee Society Functional and Range-of-Motion
Knee Scores and (2) component survivorship. This was a retrospective analysis of 100
patients undergoing revision TKA due to an aseptic etiology, who were matched to a
cohort of 100 patients who underwent primaries with the same prosthesis. There were
no differences in the groups with respect to age at surgery, sex, and body mass index.
The mean follow-up was 57 months in the revision group (range 24–105 months) and 67
months in the primary TKA group (range 55–123 months). American Knee Society Scores
(KSS) and range of motion measurements recorded preoperatively and at the most recent
postoperative visit were compared between both cohorts in order to compare postoperative
outcomes. A p value of 0.05 was used for significance. The average improvement between
the pre- and postoperative KSS function scores in both groups was similar, with both
cohorts demonstrating a 28-point improvement. At 2-year follow-up, all-cause survivorship
of the aseptic revision surgeries was 87%. Patients undergoing revision TKA for aseptic
loosening can potentially expect similar improvements in clinical function scores
and survivorship compared to primary TKA when controlling for implant type.
Keywords
revision total knee arthroplasty - survivorship - clinical outcomes - complications
