Clinical Outcomes Following Revision Total Knee Arthroplasty: Minimum 2-Year Follow-up

The longer-term outcomes of revision total knee arthroplasty are not well described in the current literature. Managing patient expectations of revision total knee arthroplasty can be challenging for orthopedic surgeons due to a paucity of data to guide decision-making. We present outcomes of revision total knee arthroplasty performed by a single surgeon over a 12-year period from 2004 through 2015.

A retrospective review of hospital and private medical records demonstrated 202 revision total knee arthroplasties performed by the senior author in 178 patients from 2004 through 2015. Of these, 153 patients were available for assessment. Patients were contacted and invited to participate in a structured telephone interview to assess Oxford Knee Score (OKS) and patient satisfaction. All patients received the PFC (Depuy) prosthesis at a single institution and were followed up for minimum 2 years postoperatively at the time of review. Retrospective chart review was used to obtain other data for analysis including patient demographics, preoperative and postoperative range of motion (ROM), and intraoperative details.

This cohort demonstrated a 93.5% survival rate and an 85% satisfaction rate at a mean of 6.5 years postoperatively. Mean ROM improved from 100° (range, 5°-145°) to 112° (range, 35°-135°) (p < 0.001). The mean OKS was 39.25 (range, 14-48). The factors associated with improved postoperative outcomes included male gender, fewer previous revision total knee arthroplasty procedures, increased preoperative ROM, and receiving a less constrained implant.

This study provides a comprehensive description of outcomes following revision total knee arthroplasty in a large patient cohort with a long follow-up. Although revision total knee arthroplasty is a challenging and complex aspect of arthroplasty surgery, high patient satisfaction and good functional outcomes can be achieved for the majority of patients.