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Performance-based Functional Outcomes After Primary vs Predominantly Septic First-time Revision TKA
Kevser Sevik Kacmaz1, Tuba Unver2, Bayram Unver2
1Incesu Ayse and Saffet Arslan Vocational School of Health Services, Kayseri University, Department of Physiotherapy, Turkey, Incesu, Kayseri.
Zeitschrift Fur Orthopadie Und Unfallchirurgie
|April 27, 2026
Summary
Revision total knee arthroplasty (rTKA) patients show poorer functional performance in walking and balance compared to primary total knee arthroplasty (TKA) patients. This highlights the need for improved primary TKA durability and tailored rehabilitation for rTKA.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Rehabilitation science
Background:
- Total knee arthroplasty (TKA) outcomes are typically assessed by survival rates.
- Patient-reported outcomes are increasingly studied, but functional performance differences between primary and revision TKA (rTKA) are not well-documented.
- Limited data exists on functional performance disparities between primary TKA and rTKA.
Purpose of the Study:
- To compare the functional performance between patients undergoing primary TKA and those undergoing rTKA.
- To evaluate differences in specific functional metrics such as walking speed, balance, and stepping ability.
- To provide insights into patient expectations and rehabilitation needs following TKA and rTKA.
Main Methods:
- A study included 29 patients who underwent either primary TKA or rTKA.
- Performance-based tests administered included the 3-meter Backwards Walk Test (3MBWT), modified Four Square Step Test (mFSST), and Figure-of-Eight Walk Test (F8WT).
- Pain levels and Hospital for Special Surgery (HSS) knee scores were also recorded.
Main Results:
- No significant differences were found in age, gender, BMI, time after surgery, pain, or HSS scores between the groups.
- The rTKA group predominantly underwent surgery for sepsis (26/29 patients).
- Patients in the rTKA group scored significantly lower on the 3MBWT, mFSST, and F8WT compared to primary TKA patients (p < 0.05).
Conclusions:
- Functional performance, including fall risk, dynamic balance, and walking skills, is poorer after predominantly septic rTKA compared to primary TKA.
- These findings help set realistic expectations for patients undergoing TKA and rTKA, particularly those with septic indications.
- Efforts to enhance primary TKA longevity and individualized, intensive rehabilitation for rTKA patients are recommended.
