PMID- 34676450
OWN - NLM
STAT- MEDLINE
DCOM- 20230228
LR  - 20230309
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 31
IP  - 3
DP  - 2023 Mar
TI  - Aseptic revision total knee arthroplasty outcomes were equivalent to patients' 
      own pre-failure state but inferior to patients without revision.
PG  - 822-829
LID - 10.1007/s00167-021-06776-5 [doi]
AB  - 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.
CI  - (c) 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy 
      (ESSKA).
FAU - Khow, Yong Zhi
AU  - Khow YZ
AUID- ORCID: 0000-0003-4173-1726
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore.
FAU - Liow, Ming Han Lincoln
AU  - Liow MHL
AUID- ORCID: 0000-0002-4496-8035
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore. 
      lincoln.liow.m.h@singhealth.com.sg.
FAU - Goh, Graham S
AU  - Goh GS
AUID- ORCID: 0000-0002-7337-3321
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore.
FAU - Chen, Jerry Yongqiang
AU  - Chen JY
AUID- ORCID: 0000-0001-7292-0170
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore.
FAU - Lo, Ngai Nung
AU  - Lo NN
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore.
FAU - Yeo, Seng Jin
AU  - Yeo SJ
AD  - Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, 
      Academia, Level 4, Singapore, 169856, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20211021
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Knee/methods
MH  - Knee Joint/surgery
MH  - Quality of Life
MH  - Minimal Clinically Important Difference
MH  - Treatment Outcome
MH  - *Osteoarthritis, Knee/surgery
MH  - *Knee Prosthesis
OTO - NOTNLM
OT  - Knee arthroplasty
OT  - Longitudinal
OT  - Outcomes
OT  - Paired
OT  - Quality of life
OT  - Revision
EDAT- 2021/10/23 06:00
MHDA- 2023/03/03 06:00
CRDT- 2021/10/22 06:59
PHST- 2021/07/15 00:00 [received]
PHST- 2021/10/13 00:00 [accepted]
PHST- 2021/10/23 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2021/10/22 06:59 [entrez]
AID - 10.1007/s00167-021-06776-5 [pii]
AID - 10.1007/s00167-021-06776-5 [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):822-829. doi: 
      10.1007/s00167-021-06776-5. Epub 2021 Oct 21.