Causes and Clinical Outcomes of Revision Total Knee Arthroplasty

Lee, Dong-Hyun; Lee, Seunghun; Song, Eun-Kyoo; Seon, Jong-Keun; Lim, Hong-An; Yang, Hong-Yeol

doi:10.5792/ksrr.16.035

Cited by 63 publications

(51 citation statements)

References 21 publications

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“…MCID is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. 17 While previous studies on rTKA did demonstrate significant improvements in outcomes, 14,15 to the authors' knowledge this is the first to analyze the results using the MCID criteria.…”

Section: Discussionmentioning

confidence: 96%

“…Five-year outcomes of revision TKA stratified by cause Kim et al, in their study of 228 knees, reported a mean flexion of 105 degrees, KSKS of 87.9, and a KSFS of 64. 14 In a recent study by Lee et al, 225 patients who underwent rTKA achieved a mean KSS of 82.6 at a minimum follow-up of 2 years 15. However, the SF-36 outcomes for this study's cohort of patients are a cause for concern.…”

mentioning

confidence: 80%

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Satisfaction Rates Are Low following Revision Total Knee Arthroplasty in Asians Despite Improvements in Patient-Reported Outcome Measures

et al. 2019

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With the aging population in Asia and increase in total knee arthroplasty (TKA) utilization rates, the number of patients requiring revision TKA (rTKA) are expected to increase as well. The purpose of this study was to evaluate outcomes and satisfaction rates following rTKA in an Asian population that has unique cultural demands. Registry data of patients who underwent rTKA from 2006 to 2010 and had completed 5 years of follow-up were analyzed. Flexion range, Oxford Knee score (OKS), Knee Society score (KSS), the Short-Form 36 (SF-36), and satisfaction rates were assessed for improvement from preoperative values, as well as by the minimum clinically important difference (MCID) criterion. rTKA was performed in 163 patients. There were significant improvements seen at 2 years postoperatively and these were sustained up to 5 years. The minimal clinically important difference (MCID) criterion for KSS, OKS, and SF-36 physical component score (PCS) was met at 2 and 5 years postoperatively. The overall complication rate was 3.7% at a mean follow-up of 8.4 years. A total of 121 patients (74.2%) were satisfied at 5 years postoperatively. Within our cohort, rTKA results in significantly improved patient-reported outcome measures with a low complication rate of 3.7% at a minimum of 5-year follow-up. Despite these encouraging results, satisfaction rates remain low.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 80%

Satisfaction Rates Are Low following Revision Total Knee Arthroplasty in Asians Despite Improvements in Patient-Reported Outcome Measures

et al. 2019

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“…This was a retrospective study that started with 154 patients, who underwent primary TKA using the same prosthesis due to end-stage osteoarthritis (OA) at our institution, from February 2014 to November 2015. Of these, 16 were excluded because of a history or objective evidence of rheumatoid arthritis [5], posttraumatic arthritis [6], concomitant neuronal disease [3], weakness or severe instability in the operated limb [2]. Patients who with less than 2 years of follow-up were also excluded [8].…”

Section: Methodsmentioning

confidence: 99%

“…Proper implant positioning and sizing are crucial for successful total knee arthroplasty (TKA) [1][2][3][4]. Anterior referencing (AR) and posterior referencing (PR) systems are the two major systems for positioning and sizing of the femoral component.…”

Section: Introductionmentioning

confidence: 99%

Posterior condylar offset changes and its effect on clinical outcomes after posterior-substituting, fixed-bearing total knee arthroplasty: anterior versus posterior referencing

Chang

Kang

Chang

et al. 2020

Knee Surg & Relat Res

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Background: We sought to determine whether there was a difference in the posterior condylar offset (PCO), posterior condylar offset ratio (PCOR) and clinical outcomes following total knee arthroplasty (TKA) with anterior referencing (AR) or posterior referencing (PR) systems. We also assessed whether the PCO and PCOR changes, as well as patient factors were related to range of motion (ROM) in each referencing system. Methods: This retrospective study included 130 consecutive patients (184 knees) with osteoarthritis who underwent primary posterior cruciate ligament (PCL)-substituting fixed-bearing TKA. The difference between preoperative and postoperative PCO and PCOR values were calculated. Clinical outcomes including ROM and Western Ontario and McMaster University (WOMAC) scores were evaluated. Furthermore, multiple linear regression analysis was performed to determine the factors related to postoperative ROM in each referencing system. Results: The postoperative PCO was greater in the AR group (28.4 mm) than in the PR group (27.4 mm), whereas the PCO was more consistently preserved in the PR group. The mean postoperative ROM after TKA was greater in the AR group (129°) than in the PR group (122°), whereas improvement in WOMAC score did not differ between the two groups. Preoperative ROM was the only factor related to postoperative ROM in both groups. Conclusions: There was no difference in postoperative PCO in AR and PR group and the PCO was not associated with postoperative ROM. PCO was more consistently preserved after surgery in the PR group. The postoperative PCO and PCOR changes did not affect the postoperative ROM. Furthermore, similar clinical outcomes were achieved in the AR and PR groups. Trial registration: Retrospectively registered (Trial registration number: 06-2010-110).

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“…Most rTKA failures occur in the first two years following surgery [ 23 ]. Infection, aseptic loosening, and instability are categorized as the three main causes for failure following rTKA surgery [ 24 , 25 , 26 , 27 ]. Although infection is the principal cause of complication after rTKA, periprosthetic fracture, extensor mechanism insufficiency and stiffness increase the risk of further surgical intervention [ 28 ].…”

Section: Complications After Rtkamentioning

confidence: 99%

The Role of Poly(Methyl Methacrylate) in Management of Bone Loss and Infection in Revision Total Knee Arthroplasty: A Review

Hasandoost

Rodriguez

Alhalawani

et al. 2020

JFB

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Poly(methyl methacrylate) (PMMA) is widely used in joint arthroplasty to secure an implant to the host bone. Complications including fracture, bone loss and infection might cause failure of total knee arthroplasty (TKA), resulting in the need for revision total knee arthroplasty (rTKA). The goals of this paper are: (1) to identify the most common complications, outside of sepsis, arising from the application of PMMA following rTKA, (2) to discuss the current applications and drawbacks of employing PMMA in managing bone loss, (3) to review the role of PMMA in addressing bone infection following complications in rTKA. Papers published between 1970 to 2018 have been considered through searching in Springer, Google Scholar, IEEE Xplore, Engineering village, PubMed and weblinks. This review considers the use of PMMA as both a bone void filler and as a spacer material in two-stage revision. To manage bone loss, PMMA is widely used to fill peripheral bone defects whose depth is less than 5 mm and covers less than 50% of the bone surface. Treatment of bone infections with PMMA is mainly for two-stage rTKA where antibiotic-loaded PMMA is inserted as a spacer. This review also shows that using antibiotic-loaded PMMA might cause complications such as toxicity to surrounding tissue, incomplete antibiotic agent release from the PMMA, roughness and bacterial colonization on the surface of PMMA. Although PMMA is the only commercial bone cement used in rTKA, there are concerns associated with using PMMA following rTKA. More research and clinical studies are needed to address these complications.

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Causes and Clinical Outcomes of Revision Total Knee Arthroplasty

Cited by 63 publications

References 21 publications

Satisfaction Rates Are Low following Revision Total Knee Arthroplasty in Asians Despite Improvements in Patient-Reported Outcome Measures

Satisfaction Rates Are Low following Revision Total Knee Arthroplasty in Asians Despite Improvements in Patient-Reported Outcome Measures

Posterior condylar offset changes and its effect on clinical outcomes after posterior-substituting, fixed-bearing total knee arthroplasty: anterior versus posterior referencing

The Role of Poly(Methyl Methacrylate) in Management of Bone Loss and Infection in Revision Total Knee Arthroplasty: A Review

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