Influence of Hospital Volume on Revision Rate After Total Knee Arthroplasty with Cement

Badawy, Mona; Espehaug, Birgitte; Indrekvam, Kari; Engesæter, Lars B.; Havelin, Leif Ivar; Furnes, Ove

doi:10.2106/jbjs.l.00943

Cited by 39 publications

(50 citation statements)

References 24 publications

(30 reference statements)

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“…The adjusted Cox regression curves comparing the 3 time periods for primary TKA vs. TKA after HTO showed an improvement over time in both groups, as has been described previously for TKA in another study (Badawy et al 2013) (Figure 6). The TKA-post-HTO group showed inferior survival results for the 2 latest time periods, whereas this group had better survival than the primary TKA group in the first time period.…”

Section: Resultssupporting

confidence: 81%

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Badawy¹,

Fenstad²,

Indrekvam³

et al. 2015

Acta Orthopaedica

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Background and purpose — Previous studies have found different outcomes after revision of knee arthroplasties performed after high tibial osteotomy (HTO). We evaluated the risk of revision of total knee arthroplasty with or without previous HTO in a large registry material.Patients and methods — 31,077 primary TKAs were compared with 1,399 TKAs after HTO, using Kaplan-Meier 10-year survival percentages and adjusted Cox regression analysis.Results — The adjusted survival analyses showed similar survival in the 2 groups. The Kaplan-Meier 10-year survival was 93.8% in the primary TKA group and 92.6% in the TKA-post-HTO group. Adjusted RR was 0.97 (95% CI: 0.77–1.21; p = 0.8).Interpretation — In this registry-based study, previous high tibial osteotomy did not appear to compromise the results regarding risk of revision after total knee arthroplasty compared to primary knee arthroplasty.

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Section: Resultssupporting

confidence: 81%

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Badawy¹,

Fenstad²,

Indrekvam³

et al. 2015

Acta Orthopaedica

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“…Further studies should be done to investigate whether revision procedures should be done at fewer institutions. We already know that high-volume hospitals have fewer revisions in primary TKA ( Badawy et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Failure of aseptic revision total knee arthroplasties

Leta¹,

Lygre²,

Skredderstuen³

et al. 2014

Acta Orthopaedica

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Background and purposeIn Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties.MethodThis study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint.Results145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6).InterpretationIn terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

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“…The Swedish Knee Arthroplasty Register showed an improvement in 10-year survival from 89% for TKAs performed during 1985 to 1994 to 96% during 2005 to 2014, and the 10-year survival rate for UKAs was 86% [40,45]. In Norway, there has been an increase in TKAs and UKAs performed in high-volume hospitals since 1994, and these hospitals have shown a lower risk of revision [4,5]. From 2000, there has been an increase in the number of hospitals with an annual UKA volume greater than 21, but also an increase in the number of hospitals with fewer than 10 UKAs annually [5].…”

Section: Survival Free From Revisionmentioning

confidence: 99%

Have the Causes of Revision for Total and Unicompartmental Knee Arthroplasties Changed During the Past Two Decades?

Dyrhovden

Lygre

Badawy

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Influence of Hospital Volume on Revision Rate After Total Knee Arthroplasty with Cement

Abstract: Background: The number of total knee replacements has substantially increased worldwide over the past ten years.

Cited by 39 publications

References 24 publications

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

The risk of revision in total knee arthroplasty is not affected by previous high tibial osteotomy

Failure of aseptic revision total knee arthroplasties

Have the Causes of Revision for Total and Unicompartmental Knee Arthroplasties Changed During the Past Two Decades?

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