Abstract
To assess primary and revision knee arthroplasty revision activity in a single English health region, and identify trends and reasons for revision surgery.
Surgeons performing knee arthroplasty surgery in Trent Region (Population 5.13 million: 16 hospitals : 107 Consultant Orthopaedic Surgeons) provide the Trent Arthroplasty Audit Group with patient and operative details by completing a standard proforma. Data capture is optimised by a peripatetic clerk checking theatre and admission records in each hospital
18762 primary knee arthroplasties were performed in Trent Region in the period 1990 – 1999.
949 revision knee arthroplasties were performed between 1992 and 1999.
In the last 10 years the number of TKA’s implanted in patients aged 55 yrs or less increased by 300%, there was a corresponding increase of 380% in patients aged 85 yrs. or over whilst the number of patients who had their knee replaced for rheumatoid arthritis decreased by 59%. 83% of patients are satisfied with their TKA when questioned 1 year post surgery. 52 of the 87 surgeons who perform TKA revision perform less than 1 per year whilst 30% of the revisions are performed by 4 surgeons in this region. The reasons for revision TKA were:
| Aseptic loosening | 38% |
| Infection | 24% |
| Implant failure | 8% |
| Instability | 7% |
| Patellofemoral pain | 5% |
5% of knees revised for infection required further revision surgery for recurrence of the infection.
The Trent Knee Arthroplasty Register has the potential to help us evaluate TKA outcome and set standards in a U.K. settting.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
