Revision total knee arthroplasty versus primary total knee arthroplasty: a matched cohort study. (March 2020)

• Record Type: Journal Article
• Authors: Stirling, Paul; Middleton, Scott D.; Brenkel, Ivan J.; Walmsley, Phil J.
• Is Part Of: Bone & joint open. Volume 1:Number 3(2020)
• Page Start: 29
• Page End: 34
• Publication Date: 2020-03
• Subjects: Orthopedic surgery -- Periodicals; Musculoskeletal system -- Surgery -- Periodicals; 617.47
• DOI: 10.1302/2046-3758.13.BJO-2019-0001.R1
• Languages: English
• ISSNs: 2633-1462

Abstract

Abstract : Introduction: The primary aim of this study was to describe a baseline comparison of early knee-specific functional outcomes following revision total knee arthroplasty (TKA) using metaphyseal sleeves with a matched cohort of patients undergoing primary TKA. The secondary aim was to compare incidence of complications and length of stay (LOS) between the two groups. Methods: Patients undergoing revision TKA for all diagnoses between 2009 and 2016 had patient-reported outcome measures (PROMs) collected prospectively. PROMs consisted of the American Knee Society Score (AKSS) and Short-Form 12 (SF-12). The study cohort was identified retrospectively and demographics were collected. The cohort was matched to a control group of patients undergoing primary TKA. Results: Overall, 72 patients underwent revision TKA and were matched with 72 primary TKAs with a mean follow-up of 57 months (standard deviation (SD) 20 months). The only significant difference in postoperative PROMs was a worse AKSS pain score in the revision group (36 vs 44, p = 0.002); however, these patients still produced an improvement in the pain score. There was no significant difference in improvement of AKSS or SF-12 between the two groups. LOS (9.3 days vs 4.6 days) and operation time (1 hour 56 minutes vs 1 hour 7 minutes) were significantly higher in the revision group (p < 0.001). Patients undergoing revision were significantly more likely to require intraoperative lateral release and postoperative urinary catheterisation (p < 0.001). Conclusion: This matched-cohort study provides results of revision TKA using modern techniques and implants and outlines what results patients can expect to achieve using primary TKA as a control. This should be useful to clinicians counselling patients for revision TKA.