Aseptic Revision Knee Arthroplasty With Total Stabilizer Prostheses Achieves Similar Functional Outcomes to Primary Total Knee Arthroplasty at 2 Years: A Longitudinal Cohort Study

J Arthroplasty. 2017 Apr;32(4):1234-1240.e1. doi: 10.1016/j.arth.2016.10.028. Epub 2016 Oct 31.

Abstract

Background: Patient function is poorly characterized following revision total knee arthroplasty (TKA), although is generally accepted to be inferior to that following primary procedures.

Methods: Fifty-three consecutive aseptic revisions to total stabilizer devices were prospectively evaluated, preoperatively and at 6, 26, 52, and 104 weeks postoperatively, using the Oxford Knee Score (OKS), range of motion, pain rating scale, and timed functional performance battery. Data were assessed longitudinally and in comparison to primary TKA data with identical outcome assessments at equivalent time points.

Results: Mean outcome changes were: 13 point increase in the OKS (from 17.5 [standard deviation-SD 7.4]-32.4 [SD 7.9] points); 21 degree improvement in the knee flexion (80.6 [SD 20.5]-101.5 [SD 13.2] degrees); 60% reduction in the pain report (7.7 [SD 2.3]-1.3 [SD 0.4] points); and 15 second improvement in the timed performance assessment (47.2 [SD 19.1]-32.0 [SD 7.0] seconds; P < .001). No difference was seen between primary and revision cohorts in OKS or pain scores (analysis of variance, P = .2 and .19). Knee flexion and timed performance assessment were different between primary and revision groups (analysis of variance, P = .03 and P = .02); however, this was due to differing preoperative values. The revision cohort achieved the same postoperative scores as the primary cohort at all postoperative time points.

Conclusion: Patients undergoing revision TKA for aseptic failure with total stabilizer implants made substantial improvements in the initial 2 years following surgery in both patient-reported and directly assessed function, comparable with that achieved following primary knee arthroplasty.

Keywords: functional outcomes; knee arthroplasty; patient outcomes; physical performance; revision knee arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Knee / instrumentation
  • Arthroplasty, Replacement, Knee / statistics & numerical data*
  • Cohort Studies
  • Female
  • Humans
  • Knee Prosthesis*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pain
  • Pain Measurement
  • Patient Reported Outcome Measures
  • Prosthesis Failure
  • Range of Motion, Articular
  • Recovery of Function
  • Reoperation / statistics & numerical data*
  • Treatment Outcome