Reasons for failure in primary total knee arthroplasty - An analysis of prospectively collected registry data.
Failure
Implants
Indication
Revision
Switzerland
Total knee arthroplasty
Total knee replacement
Journal
Journal of orthopaedics
ISSN: 0972-978X
Titre abrégé: J Orthop
Pays: India
ID NLM: 101233220
Informations de publication
Date de publication:
Historique:
received:
01
11
2020
accepted:
08
12
2020
entrez:
18
1
2021
pubmed:
19
1
2021
medline:
19
1
2021
Statut:
epublish
Résumé
The aim of this study was to determine the causes leading to a first revision of primary total knee arthroplasty (TKA) in a specialized knee centre and compare the results with previously published data. Prospectively collected data of a consecutive number of 195 patients after primary TKA and who underwent first revision surgery after completing the diagnostic algorithm for persistent knee pain were included. Data was prospectively collected from a specialized knee centre in which the patients presented between 2015 and 2020 and retrospectively analysed. Indications for revision surgery were categorized using all available information from patients' records. Patients were divided into early (up to two years) and late revision (more than two years). Overall mean time from index to revision surgery was 3.6 years. 49% of knee revisions occurred in the first two years, 51% after two years. 86% of the patients were referred to the knee centre from other surgeons. The most frequent reason for revision was instability, followed by patellofemoral problems, extensor mechanism insufficiency and malalignment. The most frequently performed revision was complete removal and re-implantation of a semi constrained implant design (52.5%) followed by revision using a full constrained implant design (16%). Secondary patella-resurfacing as part of complete revision was carried out in 71.5% of the cases. The majority of the patients showed concurrent reasons for TKA failure with significant correlations amongst another. Furthermore, correlations were identified between indications for revision surgery and revision implant designs. In a specialized knee centre the most common indications for the first TKA revision were instability and patellofemoral and/or extensor mechanism insufficiency followed by malalignment. In most patients there was not only one failure mode, but a combination of many. It is important to establish a standardized diagnostic algorithm to facilitate comprehensive and efficient diagnostics and the optimal treatment.
Identifiants
pubmed: 33456217
doi: 10.1016/j.jor.2020.12.008
pii: S0972-978X(20)30362-7
pmc: PMC7797490
doi:
Types de publication
Journal Article
Langues
eng
Pagination
60-66Informations de copyright
© 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
None declared.
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