Isolated versus Full-Component Revision Total Knee Arthroplasty for Aseptic Loosening: Systematic Review and...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Aseptic loosening is a significant complication following total knee arthroplasty (TKA).
• Limited literature summarizes outcomes comparing isolated versus full component revision TKA (rTKA).

Purpose of the Study:

• To conduct a systematic review and meta-analysis on outcomes of isolated versus full component rTKA.
• To clarify inconsistent conclusions in existing literature regarding rTKA strategies.

Main Methods:

• Systematic literature search across Embase, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov.
• Inclusion of 11 studies for meta-analysis assessing complications, implant failures, and functional results.
• Bias quality assessment performed on all included studies.

Main Results:

• Comparable re-revision rates between isolated and full component rTKA (OR: 1.36, P=0.094).
• Similar rates for aseptic loosening and periprosthetic joint infection between the two revision types.
• Isolated component rTKA demonstrated significantly reduced operative time (SMD=2.85, P<0.001) and potentially lower blood loss.

Conclusions:

• Isolated component revision offers comparable outcomes to full component revision in TKA.
• Supports isolated component revision as a less morbid option when existing components are well-fixed.
• Further prospective, longer-term studies are needed to confirm these findings.