Outcomes in revision total knee arthroplasty (Review)

Roman, Mihai Dan; Russu, Octav; Mohor, Calin; Necula, Radu; Boicean, Adrian; Todor, Adrian; Mohor, Cosmin Ioan; Fleacă, Radu

doi:10.3892/etm.2021.10951

Cited by 15 publications

(7 citation statements)

References 39 publications

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Section: Discussionsupporting

confidence: 90%

“…The overall mean reduction in pain scores was above the MCII threshold and within the PASS level. Our findings are similar to those that report good results following revision TKA, although they are inferior to outcomes following primary TKA (2,4,13,17,18). The pain levels seen in our study are in line with prior work that discussed revision TKA (4,11,17), with clinically significant pain reduction and an acceptable patient symptom state.…”

Section: Discussionsupporting

confidence: 90%

“…As the number of total knee arthroplasties (TKA) performed per year worldwide increases, so has the demand for revision TKA ( 1 ). Although the clinical outcomes following revision TKA are good, they are inferior to those after primary TKA ( 2 ). The main goal of both primary and revision arthroplasty surgery is a satisfied patient.…”

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confidence: 99%

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The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry

Winther

Snorroeggen

Klaksvik

et al. 2022

ActaO

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Background and purpose: Outcomes following revision total knee arthroplasty (TKA) may depend on the indication for revision surgery. We compared pain, patient-reported outcome measures (PROMs), and patient satisfaction among different indications for an aseptic TKA revision.Patients and methods: This was a retrospective study of prospective data from an institutional registry of 178 primary TKAs revised between 2012 and 2020. Patients were grouped by the main reason for their revision: loosening, malposition, instability, or stiffness. Pain during mobilization and at rest (NRS 0–10), physical function (KOOS-PS and KSS), and quality of life (EQ-5D) were surveyed preoperatively and at 2 months and 1 year postoperatively. Patient satisfaction was evaluated through questions related to knee function and their willingness to undergo the same surgery again at 1-year follow-up.Results: Pain and PROMs improved in all groups and did not differ statistically significantly between the 4 groups at 1-year follow-up, but equivalence for pain was not confirmed between groups. Overall, pain during mobilization improved by 2.4 (95% CI 1.9–3.0) at 1-year follow-up, which was both clinically and statistically significant. Improvements were seen within 2 months of surgery, with no further improvements seen 1 year postoperatively. Approximately 2/3 of patients reported that their knee function had improved and would undergo the same surgery again, at 1-year follow-up.Conclusion: Statistically significant and clinically relevant improvements in pain and PROMs were seen in all 4 revision groups 1 year after revision TKA. These results may assist clinicians and patients during preoperative counselling.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

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The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry

Winther

Snorroeggen

Klaksvik

et al. 2022

ActaO

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“…With improving access to quality healthcare, increased awareness and higher patient expectations, a larger number of young patients are undergoing total knee replacement [ 30 ]. Hence the rates of revision surgery are expected to rise subsequently [ 20 , 31 ]. This adds morbidity to the patient while piling on to the financial burden on the healthcare system [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Cruciate retaining total knee arthroplasty has a better 10 year survival than posterior stabilized total knee arthroplasty: a systematic review and meta‐analysis

Kanna¹,

Murali

Ramanathan

et al. 2023

J. exp. orthop.

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Purpose There has been a long standing debate regarding superiority of cruciate retaining total knee arthroplasty over posterior stabilized total knee arthroplasty regarding the short-term outcomes as well as long-term survivorship. The proponents of both the techniques have published vast evidence in favor of their respective surgical method and early outcome in meta-analyses does not seem to be significantly different. The decision to select either design should depend on their long-term survivorship but the literature comparing their long-term survival is sparse.This meta-analysis was conducted in order to answer the following questions: (1) Does cruciate retaining total knee arthroplasty has a better long-term survival beyond 10 years.compared to posterior stabilized total knee arthroplasty? (2) Does cruciate retaining knee arthroplasty has higher complication rates compared to posterior stabilized total knee arthroplasty? Methods The present systematic review and meta-analysis study was carried out following PRISMA guidelines. The following databases: Embase, Web of Science, PubMed, Scopus, the Cochrane Library, Google Scholar, and CINAHL were used to search potentially interesting articles published from database inception until January 2022. Inclusion criteria for articles were: (1) retrospective comparative studies; (2) patients who had undergone a total knee arthroplasty; (3) publications evaluating the long-term survival of cruciate-retaining (CR) versus posterior stabilizing (PS) at a minimum 10 years’ follow-up; (4) publications evaluating complications of cruciate-retaining (CR) versus posterior stabilizing (PS) at a minimum 10 years’ follow-up; and (5) publications reporting sufficient data regarding the outcomes. We used a fixed-effects design in the case of I2 < 50% and P > 0.05; if not, we adopted a random-effects design [4]. We also performed subgroups and sensitivity analysis in order to assess the possible source of heterogeneity. Results Database searching identified 597 studies to be screened, of which 291 abstracts were revealed as potentially eligible and finally 7 articles were included. The forest plot showed that CR had significantly better survival than PS (OR = 2.17; 95% CI: 1.69–2.80) after 10 years. However, complication rate was not significantly different between CR and PS groups (OR = 0.86; 95% CI: 0.52–1.44; P = 0.57). Subgroup analysis showed that only the period of publication constituted a source of heterogeneity in survivorship outcome. Sensitivity analysis revealed that outcomes did not differ markedly, which indicates that the meta-analysis had strong reliability. Conclusion The results of this meta-analysis showed that cruciate retaining prosthesis may be preferred over the posterior stabilized design in view of longer survivorship it offers However, further randomized controlled trials are recommended to confirm this finding.

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“…Compared to primary TKA, rTKA is associated with a higher risk of complications and revision procedures [ [8] , [9] , [10] , [11] , [12] ]. Risk factors for poor outcomes after rTKA include the quality of the index primary TKA, indication for rTKA, and comorbidities such as obesity, diabetes, and tobacco use [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Hepatitis C on Complication Rates After Revision Total Knee Arthroplasty: A Matched Cohort Study

Ross¹,

Ross²,

Cole³

et al. 2022

Arthroplasty Today

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Outcomes in revision total knee arthroplasty (Review)

Cited by 15 publications

References 39 publications

The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry

The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry

Cruciate retaining total knee arthroplasty has a better 10 year survival than posterior stabilized total knee arthroplasty: a systematic review and meta‐analysis

The Impact of Hepatitis C on Complication Rates After Revision Total Knee Arthroplasty: A Matched Cohort Study

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