Aseptic revision total knee arthroplasty outcomes were equivalent to patients' own pre-failure state but inferior to patients without revision
© 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)..
PURPOSE: The purpose of this study was to (1) longitudinally compare the patient-reported outcome measures (PROMs) of the same patients who underwent primary TKA and revision TKA, and (2) compared the results of these revision TKA with a matched cohort of well-functioning primary TKA. The hypothesis was revision TKA could result in equivalent outcomes to patients' own primary TKA or the primary TKA of patients who did not require revision.
METHODS: Prospectively collected data of 123 patients who underwent primary TKA and subsequently aseptic revision TKA ("revised group"), were matched using nearest-neighbor method to 123 well-functioning primary TKA that did not require revision ("control group"). Preoperative (prior to primary TKA), at time of failure (prior to revision TKA), postoperative 6-month and 2-year PROMs included Knee Society scores (KSS), Oxford Knee Score (OKS) and Short Form-36 (SF-36). Minimal clinically important difference (MCID) attainment was analyzed. Wilcoxon and McNemar's tests were used to compare outcomes within the revised group (primary vs revision), Mann-Whitney U test and Chi-Square test for the revised and control groups.
RESULTS: The revised group had poorer KSS objective (p = 0.045), KSS functional (p < 0.001), OKS (p = 0.011) and SF-36 PCS (p < 0.001) at time of failure (prior to revision TKA), compared to their preoperative PROMs (prior to primary TKA). Revision TKA resulted in restoration of KSS objective, OKS and SF-36 PCS (NS) that were equivalent to their primary TKA, but poorer KSS functional (p < 0.050). Patients in the revised group had a lower proportion of MCID attainment in KSS objective (p = 0.014) and OKS (p < 0.001) at 2-year after primary TKA when compared to the control group. Revision TKA also led to poorer KSS objective, KSS functional and SF-36 PCS (p < 0.050) when compared to primary TKA of the control group.
CONCLUSION: Outcomes following aseptic revision were equivalent to patients' own pre-failure state but inferior to patients with non-revised implants. An individualized approach toward goal setting and assessing adequacy of aseptic revision TKA can be adopted based on patients' pre-failure outcomes.
LEVEL OF EVIDENCE: III.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA - 31(2023), 3 vom: 21. März, Seite 822-829 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Khow, Yong Zhi [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 28.02.2023 Date Revised 09.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00167-021-06776-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM332166074 |
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| 041 | |a eng | ||
| 100 | 1 | |a Khow, Yong Zhi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Aseptic revision total knee arthroplasty outcomes were equivalent to patients' own pre-failure state but inferior to patients without revision |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 28.02.2023 | ||
| 500 | |a Date Revised 09.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA). | ||
| 520 | |a PURPOSE: The purpose of this study was to (1) longitudinally compare the patient-reported outcome measures (PROMs) of the same patients who underwent primary TKA and revision TKA, and (2) compared the results of these revision TKA with a matched cohort of well-functioning primary TKA. The hypothesis was revision TKA could result in equivalent outcomes to patients' own primary TKA or the primary TKA of patients who did not require revision | ||
| 520 | |a METHODS: Prospectively collected data of 123 patients who underwent primary TKA and subsequently aseptic revision TKA ("revised group"), were matched using nearest-neighbor method to 123 well-functioning primary TKA that did not require revision ("control group"). Preoperative (prior to primary TKA), at time of failure (prior to revision TKA), postoperative 6-month and 2-year PROMs included Knee Society scores (KSS), Oxford Knee Score (OKS) and Short Form-36 (SF-36). Minimal clinically important difference (MCID) attainment was analyzed. Wilcoxon and McNemar's tests were used to compare outcomes within the revised group (primary vs revision), Mann-Whitney U test and Chi-Square test for the revised and control groups | ||
| 520 | |a RESULTS: The revised group had poorer KSS objective (p = 0.045), KSS functional (p < 0.001), OKS (p = 0.011) and SF-36 PCS (p < 0.001) at time of failure (prior to revision TKA), compared to their preoperative PROMs (prior to primary TKA). Revision TKA resulted in restoration of KSS objective, OKS and SF-36 PCS (NS) that were equivalent to their primary TKA, but poorer KSS functional (p < 0.050). Patients in the revised group had a lower proportion of MCID attainment in KSS objective (p = 0.014) and OKS (p < 0.001) at 2-year after primary TKA when compared to the control group. Revision TKA also led to poorer KSS objective, KSS functional and SF-36 PCS (p < 0.050) when compared to primary TKA of the control group | ||
| 520 | |a CONCLUSION: Outcomes following aseptic revision were equivalent to patients' own pre-failure state but inferior to patients with non-revised implants. An individualized approach toward goal setting and assessing adequacy of aseptic revision TKA can be adopted based on patients' pre-failure outcomes | ||
| 520 | |a LEVEL OF EVIDENCE: III | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Knee arthroplasty | |
| 650 | 4 | |a Longitudinal | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Paired | |
| 650 | 4 | |a Quality of life | |
| 650 | 4 | |a Revision | |
| 700 | 1 | |a Liow, Ming Han Lincoln |e verfasserin |4 aut | |
| 700 | 1 | |a Goh, Graham S |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Jerry Yongqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Lo, Ngai Nung |e verfasserin |4 aut | |
| 700 | 1 | |a Yeo, Seng Jin |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:31 |g year:2023 |g number:3 |g day:21 |g month:03 |g pages:822-829 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00167-021-06776-5 |3 Volltext |
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