Abstract
By 1998, 10 patients had undergone 12 revision total knee arthroplasties at our institute. One patient died three weeks after surgery due to cerebral infarction, leaving 11 knees of nine patients for evaluation. Average follow-up was 4.8 years (1 to 9 years). All components were subjected to revision surgery in five knees, the tibial tray and insert in four knees, and only the insert in two knees. Patients were evaluated with clinical examinations, radiographs, and the Knee Society Clinical Rating System.
After revision surgery, the Knee Scores and ROMs were restored to almost the same level as just after the first TKA. Re-revision was performed on two patients, one 103 months and the other 82 months after revision TKA. In those two patients, huge bone loss of the proximal tibial canal was filled with cement without bone graft. The other patients, however whose tibial trays were fixed with cement on adequate grafted bone obtained good results.
The femoral components that were not treated with revision surgery despite small flaws or scratches due to wear and tear of the tibial insert did not cause marked wear of the new tibial insert.
Conclusion: Bone loss of the proximal tibial canal should be filled with bone graft, not with cement only. Femoral components with small flaws or scratches, and without other ploblems, need not to be treated with revision surgery.
The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
