The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry

Abstract

Background and purpose — Outcomes following revision total knee arthroplasty (TKA) may depend on the indication for revision surgery. We compared pain, patient-reported outcome measures (PROMs), and patient satisfaction among different indications for an aseptic TKA revision. Patients and methods — This was a retrospective study of prospective data from an institutional registry of 178 primary TKAs revised between 2012 and 2020. Patients were grouped by the main reason for their revision: loosen-ing, malposition, instability, or stiffness. Pain during mobili-zation and at rest (NRS 0–10), physical function (KOOS-PS and KSS), and quality of life (EQ-5D) were surveyed preop-eratively and at 2 months and 1 year postoperatively. Patient satisfaction was evaluated through questions related to knee function and their willingness to undergo the same surgery again at 1-year follow-up. Results — Pain and PROMs improved in all groups and did not differ statistically significantly between the 4 groups at 1-year follow-up, but equivalence for pain was not confirmed between groups. Overall, pain during mobi-lization improved by 2.4 (95% CI 1.9–3.0) at 1-year follow-up, which was both clinically and statistically significant. Improvements were seen within 2 months of surgery, with no further improvements seen 1 year postoperatively. Approxi-mately 2/3 of patients reported that their knee function had improved and would undergo the same surgery again, at 1-year follow-up. Conclusion — Statistically significant and clinically relevant improvements in pain and PROMs were seen in all 4 revision groups 1 year after revision TKA. These results may assist clinicians and patients during preoperative counselling.