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Revision total knee replacement versus primary total knee replacement : a matched cohort study

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Stirling_2020_BJO_Knee_CC.pdf (162.6Kb)
Date
13/03/2020
Author
Stirling, Paul
Middleton, Scott
Brenkel, Ivan
Walmsley, Phil
Keywords
RD Surgery
E-NDAS
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Abstract
Introduction The primary aim of this study was to describe a baseline comparison of early knee-specific functional outcomes following revision total knee arthroplasty (TKA) using metaphyseal sleeves with a matched cohort of patients undergoing primary TKA. The secondary aim was to compare incidence of complications and length of stay (LOS) between the two groups. Methods Patients undergoing revision TKA for all diagnoses between 2009 and 2016 had patient-reported outcome measures (PROMs) collected prospectively. PROMs consisted of the American Knee Society Score (AKSS) and Short-Form 12 (SF-12). The study cohort was identified retrospectively and demographics were collected. The cohort was matched to a control group of patients undergoing primary TKA. Results Overall, 72 patients underwent revision TKA and were matched with 72 primary TKAs with a mean follow-up of 57 months (standard deviation (SD) 20 months). The only significant difference in postoperative PROMs was a worse AKSS pain score in the revision group (36 vs 44, p = 0.002); however, these patients still produced an improvement in the pain score. There was no significant difference in improvement of AKSS or SF-12 between the two groups. LOS (9.3 days vs 4.6 days) and operation time (1 hour 56 minutes vs 1 hour 7 minutes) were significantly higher in the revision group (p < 0.001). Patients undergoing revision were significantly more likely to require intraoperative lateral release and postoperative urinary catheterisation (p < 0.001). Conclusion This matched-cohort study provides results of revision TKA using modern techniques and implants and outlines what results patients can expect to achieve using primary TKA as a control. This should be useful to clinicians counselling patients for revision TKA.
Citation
Stirling , P , Middleton , S , Brenkel , I & Walmsley , P 2020 , ' Revision total knee replacement versus primary total knee replacement : a matched cohort study ' , Bone & Joint Open , vol. 1 , no. 3 , pp. 29-34 . https://doi.org/10.1302/2046-3758.13.BJO-2019-0001.R1
Publication
Bone & Joint Open
Status
Peer reviewed
DOI
https://doi.org/10.1302/2046-3758.13.BJO-2019-0001.R1
ISSN
2633-1462
Type
Journal article
Rights
Copyright © 2020 Author(s) et al. This article is distributed under the terms of the Creative Commons Attribution Non-Commercial-NoDerivatives 4.0 (CC BY-NC-ND 4.0) licence (https:// creativecommons. org/ licenses/ by-nc-nd/4. 0/), which permits the copying and redistribution of the work only, and provided the original author and source are credited.
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/19656

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