Revision total knee arthroplasty: the patient's perspective

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Patient Outcomes Research

Background:

• Revision total knee arthroplasty (TKA) is a complex procedure often necessitated by primary TKA failure.
• Understanding patient perspectives and surgeon assessments is crucial for improving revision TKA outcomes.

Purpose of the Study:

• To evaluate patient satisfaction, expectations, and perceived reasons for failure after revision TKA.
• To compare patient and surgeon assessments of primary TKA failure and revision TKA outcomes.

Main Methods:

• A prospective study involving 238 patients who underwent revision TKA at three referral centers.
• Patient interviews assessed satisfaction, expectations, and reasons for primary failure.
• Review of operative reports, clinical records, and radiographs to determine revision diagnosis and failure cause.

Main Results:

• Patient satisfaction with revision TKA was 69%, but only 34% agreement existed between patient and surgeon assessments of primary failure.
• Most patients (74%) expected revision TKA to last longer than the primary procedure, irrespective of failure cause or duration.
• Patient satisfaction with the primary procedure correlated with the time to revision.

Conclusions:

• While a majority of patients are satisfied with revision TKA, significant discrepancies exist in understanding the reasons for primary failure and expectations for revision longevity.
• Addressing patient expectations and improving communication regarding failure mechanisms are essential for optimizing outcomes in revision TKA.