Functional and radiological outcomes in revision total knee arthroplasty

Authors

  • Harshith Neelaraju Department of Orthopaedics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Shashank Janardhan Department of Orthopaedics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Karthik M. Venkataramana Department of Orthopaedics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India https://orcid.org/0009-0005-6867-0574
  • Ningaraj Dyapur Department of Orthopaedics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252649

Keywords:

Total knee arthroplasty, Revision arthroplasty, Functional outcome, Pain score

Abstract

Background: Following a primary total knee arthroplasty, patients with rheumatoid arthritis and osteoarthritis are reported to have comparable clinical prognoses and overall failure rates. Information on revision techniques is limited, despite the fact that the causes of failure and survivorship for primary total knee arthroplasty (TKA) have been well investigated. This study, which investigated the radiological and functional outcomes of revision total knee arthroplasty, was conducted as a consequence of these factors.

Methods: This observational study was conducted in the Department of Orthopedics in Sapthagiri institute of medical sciences and research centre among cases who underwent revision TKA during November 2022 to June 2023. A total of forty cases who underwent RTKA during the study period were included in the study. After taking the written informed consent, principal investigator assessed the detailed history of the participants and clinically examined the patients. Pre and post-operative functional and radiological outcomes were measured. The data was entered in excel sheet and analyzed using statistical package for the social sciences (SPSS) - version 19.

Results: Pre op and post-operative HSS score, KS score including the sub-scales like objective knee score, patient satisfaction score, patient expectations core and functional activity score and radiological outcome scores were found to be statistically improved post-operatively. Also, pain was markedly reduced postoperatively based on VAS scale. However, only one case died who underwent two stages TKA, which was not statistically significant.

Conclusions: We infer that further improvement in prevention and management of infection following TKA can helps to prevent the proportion of cases requiring RTKA and thus much attention is warranted on this dreaded complication.

Metrics

Metrics Loading ...

References

Stern SH, Insall JN. Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg Am. 1992;74:980-6. DOI: https://doi.org/10.2106/00004623-199274070-00004

Kane RL, Saleh KJ, Wilt TJ, Bershadsky B, Cross WW 3rd, MacDonald RM, Rutks I. Total knee replacement. Evid Rep Technol Assess (Summ). 2003;86:1-8.

Saleh KJ, Dykes DC, Tweedie RL, Mohamed K, Ravichandran A, Saleh RM, et al. Functional outcome after total knee arthroplasty revision: a meta-analysis. J Arthroplasty. 2002;17:967-77. DOI: https://doi.org/10.1054/arth.2002.35823

Saleh KJ, Rand JA, McQueen DA. Current status of revision total knee arthroplasty: how do we assess results? J Bone Joint Surg Am. 2003;85-A(Suppl 1):S18-20 DOI: https://doi.org/10.2106/00004623-200300001-00005

Mulhall KJ, Ghomrawi HM, Scully S, Callaghan JJ, Saleh KJ. Current etiologies and modes of failure in total knee arthroplasty revision. Clin Orthop Relat Res. 2006;446:45-50. DOI: https://doi.org/10.1097/01.blo.0000214421.21712.62

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780-5. DOI: https://doi.org/10.2106/JBJS.F.00222

Dahm DL, Barnes SA, Harrington JR, Berry DJ. Patient reported activity after revision total knee arthroplasty. J Arthroplasty. 2007;22(2):S106 10. DOI: https://doi.org/10.1016/j.arth.2006.12.059

Järvenpää J, Kettunen J, Miettinen H, Kröger H. The clinical outcome of revision knee replacement after unicompart mental knee arthroplasty versus primary total knee arthroplasty: 8 17 years follow up study of 49 patients. Int Orthop. 2010;34:649 53. DOI: https://doi.org/10.1007/s00264-009-0811-4

Porteous A. Top tips and pitfalls in revision knee arthroplasty surgery. J Orthopaed Trauma. 2017;31:34 40. DOI: https://doi.org/10.1016/j.mporth.2016.10.007

Kurtz SM, Ong KL, Schmier J, Mowat F, Saleh K, Dybvik E, et al. Future clinical and economic impact of revision total hip and knee arthroplasty. J Bone Joint Surg Am. 2007;89(3):144-51. DOI: https://doi.org/10.2106/JBJS.G.00587

Laskin RS. Total condylar knee replacement in patients who have rheumatoid arthritis. A ten-year follow-up study. J Bone Joint Surg Am. 1990;72:529-35. DOI: https://doi.org/10.2106/00004623-199072040-00009

Laskin RS, O’Flynn HM. The Insall Award. Total knee replacement with posterior cruciate ligament retention in rheumatoid arthritis. Problems and complications. Clin Orthop Relat Res. 1997;345:24-8. DOI: https://doi.org/10.1097/00003086-199712000-00005

Sheng PY, Jamsen E, Lehto MU, Konttinen YT, Pajamaki J, Halonen P. Revision total knee arthroplasty with the Total Condylar III system in inflammatory arthritis. J Bone Joint Surg Br. 2005;87:1222-4. DOI: https://doi.org/10.1302/0301-620X.87B9.15933

Rooser B, Boegard T, Knutson K, Rydholm U, Lidgren L. Revision knee arthroplasty in rheumatoid arthritis. Clin Orthop Relat Res. 1987;219:169-73. DOI: https://doi.org/10.1097/00003086-198706000-00025

Emsley D, Martin J, Newell C, Pickford M, Royall M, Swanson M. The National Joint Registry 5th Annual Report. Hemel Hempstead, UK: National Joint Registry. 2008.

Mortazavi SJ, Molligan J, Austin MS, Purtill JJ, Hozack WJ, Parvizi J. Failure following revision total knee arthroplasty: infection is the major cause. Int Orthop. 2011;35:1157-64. DOI: https://doi.org/10.1007/s00264-010-1134-1

Lee KJ, Moon JY, Song EK, Lim HA, Seon JK. Minimum two-year results of revision total knee arthroplasty following infectious or non-infectious causes. Knee Surg Relat Res. 2012;24(4):227. DOI: https://doi.org/10.5792/ksrr.2012.24.4.227

Hardeman F, Londers J, Favril A, Witvrouw E, Bellemans J, Victor J. Predisposing factors which are relevant for the clinical outcome after revision total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012;20:1049-56. DOI: https://doi.org/10.1007/s00167-011-1624-8

Tay KS, Lo NN, Yeo SJ, Chia SL, Tay DK, Chin PL. Revision total knee arthroplasty: causes and outcomes. Ann Acad Med Singapore. 2013;42(4):178-83. DOI: https://doi.org/10.47102/annals-acadmedsg.V42N4p178

Meijer MF, Reininga IH, Boerboom AL, Stevens M, Bulstra SK. Poorer survival after a primary implant during revision total knee arthroplasty. Int Orthop. 2013;37:415-9. DOI: https://doi.org/10.1007/s00264-012-1739-7

Rajgopal A, Vasdev A, Gupta H, Dahiya V. Revision total knee arthroplasty for septic versus aseptic failure. J Orthop Surg. 2013;21(3):285-9. DOI: https://doi.org/10.1177/230949901302100304

Stammers J, Kahane S, Ranawat V, Miles J, Pollock R, Carrington RW, et al. Outcomes of infected revision knee arthroplasty managed by two-stage revision in a tertiary referral centre. The Knee. 2015;22(1):56-62. DOI: https://doi.org/10.1016/j.knee.2014.10.005

Lee DH, Lee SH, Song EK, Seon JK, Lim HA, Yang HY. Causes and clinical outcomes of revision total knee arthroplasty. Knee Surg Relat Res. 2017;29(2):104. DOI: https://doi.org/10.5792/ksrr.16.035

Stockwell KD, Malleck S, Gascoyne TC, Turgeon TR. Clinical and radiographic outcomes of a hybrid fixation revision total knee arthroplasty system at short to mid-term follow-up. The Knee. 2019;26(1):240-9. DOI: https://doi.org/10.1016/j.knee.2018.11.011

Evangelopoulos DS, Ahmad SS, Krismer AM, Albers CE, Hoppe S, Kleer B, et al. Periprosthetic infection: major cause of early failure of primary and revision total knee arthroplasty. J Knee Surg. 2019;32(10):941-6. DOI: https://doi.org/10.1055/s-0038-1672203

Sachdeva S, Baker JF, Bauwens JE, Smith LS, Sodhi N, Mont MA, et al. Can revision TKA patients achieve similar clinical functional improvement compared to primaries? J Knee Surg. 2019;33(12):1219-24. DOI: https://doi.org/10.1055/s-0039-1693415

Leta TH, Lygre SH, Schrama JC, Hallan G, Gjertsen JE, Dale H, et al. Outcome of revision surgery for infection after total knee arthroplasty: results of 3 surgical strategies. JBJS Rev. 2019;7(6):e4. DOI: https://doi.org/10.2106/JBJS.RVW.18.00084

Agarwal S, Kabariti R, Kakar R, Morgan-Jones R. Why are revision knee replacements failing? The Knee. 2019;26(3):774-8. DOI: https://doi.org/10.1016/j.knee.2019.04.012

Wignadasan W, Chang JS, Kayani B, Kontoghiorghe C, Haddad FS. Long-term results of revision total knee arthroplasty using a rotating hinge implant. The Knee. 2021;28:72-80. DOI: https://doi.org/10.1016/j.knee.2020.11.009

Na BR, Kwak WK, Lee NH, Song EK, Seon JK. Trend Shift in the Cause of Revision Total Knee Arthroplasty over 17 Years. Clin Orthop Surg. 2023;15(2):219-26. DOI: https://doi.org/10.4055/cios21106

Downloads

Published

2025-08-25

How to Cite

Neelaraju, H., Janardhan, S., Venkataramana, K. M., & Dyapur, N. (2025). Functional and radiological outcomes in revision total knee arthroplasty. International Journal of Research in Orthopaedics, 11(5), 1178–1183. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252649

Issue

Section

Original Research Articles