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Clinical Orthopaedics and Related Research®

Erschienen in:

01.08.2012 | Clinical Research

Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision

verfasst von: Paul Baker, MBBS, MSc, FRCS (Trauma & Orthop), Paul Cowling, MBBS, MRCS, Steven Kurtz, PhD, Simon Jameson, MBBS, MRCS, Paul Gregg, MD, FRCS (Ed), FRCS, David Deehan, MD, MSc, FRCS (Trauma & Orthop)

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 8/2012

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Abstract

Background

Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear.

Questions/purposes

We determined differences in patient-reported outcomes and rates of satisfaction between primary and revision TKAs, and determine whether the reason for revision influences patient-reported outcomes after revision TKA.

Methods

We retrospectively analyzed prospectively collected patient-reported outcome measures (PROMs) for 24,190 patients (23,393 TKAs; 797 aseptic revision TKAs). We compared patient-reported outcomes using the Oxford Knee Score (OKS), EuroQol (EQ-5D), and patient satisfaction between primary TKA and revision TKA, and for subsets of the revision TKA cohort. The followup data were collected between 6 and 12 months (7 months average) postoperatively.

Results

Improvements in the OKS (10) and EQ-5D (0.231) were smaller after revision when compared with primary TKA (OKS, 15; EQ-5D, 0.303). Patients who had revision TKA were less satisfied (66% versus 83%). Revisions for aseptic loosening or lysis were associated with the best patient outcomes (OKS improvement = 11; EQ-5D improvement = 0.232; satisfaction = 72%). Revisions for stiffness had the worst results (OKS improvement = 6; EQ-5D improvement = 0.176; satisfaction = 47%).

Conclusions

The early improvements in knee function and general health after revision TKA are only 69% to 76% of those observed for primary TKA. Levels of patient-reported knee function, general health, and satisfaction after revision are varied and related to the reason for revision. Even the best revision group does not approach the levels of function and satisfaction observed after primary TKA at a mean of 7 months postoperatively. Longer-term followup would be required to determine whether conclusions from these early data will need to be modified.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Titel: Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision
verfasst von: Paul Baker, MBBS, MSc, FRCS (Trauma & Orthop)
Paul Cowling, MBBS, MRCS
Steven Kurtz, PhD
Simon Jameson, MBBS, MRCS
Paul Gregg, MD, FRCS (Ed), FRCS
David Deehan, MD, MSc, FRCS (Trauma & Orthop)
Publikationsdatum: 01.08.2012
Verlag: Springer-Verlag
Erschienen in: Clinical Orthopaedics and Related Research® / Ausgabe 8/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2278-7

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Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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