REVISION TKR FOR SEPTIC AND ASEPTIC LOOSENING. IS THE OUTCOME DIFFERENT?

Abstract

Aim: To assess the results of aseptic and aseptic cases using the PFC/TC3 system, and to correlate this with the restoration of joint line height.

Method: 148 patients underwent revision TKR using the PFC/TC3 system. No re-revision cases were included in this series. Data was prospectively collected (using the Bristol Knee Score) pre-operatively and at a mean of 4.2 years post-revision. 31 revisions were for infection and 53 revisions were for aseptic loosening. Revision for infection was done as a two-stage procedure and aseptic as a single operation. Measurements of the joint line height were made pre and post-operatively using Figgie’s method. The cases were divided into 3 groups on the basis of joint line restoration:

• Lowered by more than 5 mm

• Restored

• Elevated more than 5 mm

Results: The mean pre-op total score for the infection group was 35/100 and 40/100 for the aseptic loosening group. The total score post-operatively was 67 for the infection group and 73 for the aseptic loosening group. The joint line was restored in 50% of infected cases and in 60% of aseptic loosening cases.

Conclusion: although the overall results were slightly less satisfactory for the infected revision group, there was no significant difference between the two groups either in total BKS scores or in reproduction of the joint line. The average outcome was much less good than for primary TKR.