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Single- versus Dual-Component Revision Following Total Knee Arthroplasty Failure for Isolated Tibial or Femoral
Tobenna N Nwankwo1, Nicholas R Olson1, Jacqueline R Ray1
1Anderson Orthopedic Research Institute, Alexandria, Virginia.
Background:
Aseptic loosening is a leading cause of failure in total knee arthroplasty (TKA). When loosening is limited to either the femoral or tibial component, the choice between single- and dual-component revision remains a debated topic. This investigation examines outcomes between single- versus dual-component revision for isolated component loosening in TKA.
Methods:
A retrospective review was conducted of 288 first-time revision TKAs performed for isolated femoral or tibial aseptic component loosening between February 2005 and December 2024 by 9 high-volume arthroplasty surgeons. The mean follow-up was 4.5 years (range, zero to 17.0). Patients were stratified by revision strategy: single- or dual-component. The primary outcome was survivorship and rerevision rate. The secondary outcomes included complications, postoperative range of motion (ROM), and patient-reported outcome measures (PROMs). Multivariable Cox regressions evaluated factors associated with rerevision risk.
Results:
Survivorship analysis showed comparable revision rates between both groups (P = 0.615). There were no differences found between the overall rerevision rate for single-component revision (11.2%, 16 of 134) and dual-component revision (9.7%, 15 of 154). The 90-day complications were similarly low in both groups (P > 0.05). Cox regressions identified no independent predictors of rerevision, including revision strategy (P > 0.05). Both cohorts demonstrated improvements in ROM and PROMs postoperatively, with no significant difference in PROMs (P > 0.05).
Conclusions:
In patients who had isolated femoral or tibial loosening, single- and dual-component revision TKA offer comparable survivorship and functional outcomes. These findings support the use of surgeon discretion in determining component retention during revision TKA.
