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

• Published in: Acta orthopaedica Vol. 93; pp. 819 - 825
• Main Authors: Winther, Siri B, Snorroeggen, Gøril Lund, Klaksvik, Jomar, Foss, Olav A, Egeberg, Tarjei, Wik, Tina Strømdal, Husby, Otto S
• Format: Journal Article
• Language: English
• Published: Sweden Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 19-10-2022; Medical Journals Sweden
• Subjects: Arthroplasty; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; Humans; Knee; Knee Joint - surgery; Pain; Prospective Studies; Prosthesis Failure; Quality of Life; Registries; Reoperation; Retrospective Studies; Treatment Outcome
• ISSN: 1745-3674; 1745-3682
• DOI: 10.2340/17453674.2022.4878

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.
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.
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.
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.