Re-revision knee arthroplasty in a tertiary center: infection and multiple previous surgeries were associated with poor early clinical and functional outcomes
Background - The incidence of re-revision knee arthroplasty (re-revision KA) is increasing and associated with high complication and failure rates. The aim of this study was to investigate re-revision rates, complications, and patient-reported outcomes following re-revision KA and factors associated...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
7 June 2023
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| In: |
The journal of arthroplasty
Year: 2023, Jahrgang: 38, Heft: 7, Pages: 1313-1319 |
| ISSN: | 1532-8406 |
| DOI: | 10.1016/j.arth.2023.01.030 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.arth.2023.01.030 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0883540323000505 
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| Verfasserangaben: | Lennart von Fritsch, MD, Shiraz A. Sabah, FRCS (Orth), Joshua Xu, MD, Andrew J. Price, FRCS (Orth), DPhil, Christian Merle, Dr MSc, Abtin Alvand, FRCS (Orth), DPhil |
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| 245 | 1 | 0 | |a Re-revision knee arthroplasty in a tertiary center |b infection and multiple previous surgeries were associated with poor early clinical and functional outcomes |c Lennart von Fritsch, MD, Shiraz A. Sabah, FRCS (Orth), Joshua Xu, MD, Andrew J. Price, FRCS (Orth), DPhil, Christian Merle, Dr MSc, Abtin Alvand, FRCS (Orth), DPhil |
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| 520 | |a Background - The incidence of re-revision knee arthroplasty (re-revision KA) is increasing and associated with high complication and failure rates. The aim of this study was to investigate re-revision rates, complications, and patient-reported outcomes following re-revision KA and factors associated with poor outcome. - Methods - This was a retrospective cohort study of 206 patients (250 knees) undergoing re-revision KA at a major revision center from 2015 to 2018. The mean follow-up was 26 months (range, 0 to 61) and mean age at re-revision KA was 69 years (range, 31 to 91 years). The main indications for surgery were prosthetic joint infection (PJI) (n = 171/250, 68.4%) and aseptic loosening (n = 25/250, 10.0%). We compared re-revision rates, joint function, and complications for aseptic and infective indications. Logistic regressions were performed to identify risk factors for further reoperation. - Results - The estimated re-revision rates at 2 years were 28.7% (95% confidence interval [CI]: 22.7-35.9) and at 4 years were 42.0% (95% CI: 32.8-52.6). Mean Oxford Knee Score was 26 points (range, 1 to 48). Mean EuroQoL-5D-5L utility was 0.539 (range, -0.511 to 1.000). Multivariable analyses demonstrated that PJI (Odds Ratio [OR] 2.39, 95% CI 1.06-5.40, P = .036), greater number of previous surgeries (OR 1.18, 95% CI 1.04-1.33, P = .008), and higher Elixhauser score (OR 1.06, 95% CI 1.01-1.13, P = .045) were independently associated to further surgery. - Conclusion - Re-revision KA carried a high risk of early failure. Multiple revised joints and patients with more comorbidities had worse function. Patients undergoing re-revision KA for PJI should be counseled to expect higher failure rates and complications than patients who have aseptic indications. | ||
| 650 | 4 | |a knee arthroplasty | |
| 650 | 4 | |a patient reported outcome (PROM) | |
| 650 | 4 | |a prosthetic joint infection | |
| 650 | 4 | |a revision | |
| 650 | 4 | |a total knee replacement | |
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| 700 | 1 | |a Xu, Joshua |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Alvand, Abtin |e VerfasserIn |4 aut | |
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