抄録
Objective: Revision surgery is one of the most serious complications after total knee arthroplasty (TKA). Revision TKA (rTKA) is very complicated and its clinical results are generally inadequate. Reports of the outcome of such revisions is rare in Japan. We herein report our results of rTKA.
Methods: Twenty patients (17 female and 3 male) who received rTKA were included in this analysis. The mean age at rTKA was 70 years (36-84 years), and the mean follow-up period was 50.1 months (range, 5-134 months). The underlying diseases were osteoarthritis in 13 patients, rheumatoid arthritis in five patients, and osteosarcoma in two patients, respectively. The period from primary TKA to rTKA and the cause of implant failure were investigated. Japanese Orthopaedic Association (JOA) osteoarthritis knee score, range of motion (ROM), Knee Society Score (KSS) clinical and function, Japanese Knee injury Osteoarthritis Outcome Score (J-KOOS), and patients’ satisfaction were evaluated. The relations between patients’ satisfaction and clinical results were examined using Spearman’s rank-order correlation.
Results: The average period between primary TKA and rTKA was 90.9 months (range, 3-320 months). The reasons for implant failure included loosening in six patients, infection in four patients, pain in three patients, wear in three patients, implant breakage in two patients, periprosthetic fracture in one patient, and instability in one patient. The JOA score was 45.3 points (range, 20-80 points) preoperatively and 64 points (range, 45-85 points) postoperatively. ROM was improved from −5.7-100° to −3.7-103°. Postoperative KSS clinical was 84.5 points (range, 30-100 points) and function was 58.6 points (range, 20-90 points). The average J-KOOS total was 58.4 (range, 20.2-80.4). 73.3% of patients were satisfied with the result of their rTKAs. The clinical score significantly related with patients’ satisfaction were quantity of flexion improvement, postoperative KSS clinical score, postoperative J-KOOS total, and postoperative J-KOOS subscale; activity of daily life.
Conclusion: The cause and clinical results of our cohort of patients who underwent rTKA were very similar to past reports. However, there are few reports of patients’ satisfaction after rTKA, and to our knowledge there have been no other well-organized studies like this. Patients in our study had a high degree of satisfaction after rTKA.
