Abstract
Total knee arthroplasty revisions (TKAR) are increasing in incidence. These complex and demanding procedures are typically associated with a higher complication rate than primaries. We report on the actual complications encountered in a prospective study of TKAR patients to determine the current nature and incidence of these problems.
230 consecutive patients undergoing TKAR were enrolled to our database and had information on demographics, comorbidities, outcomes (WOMAC and SF-36) and complications recorded. Baseline information and data from 2 month, 6 month and 1 year follow up was collated.
Mean patient age was 68.0 and clinical outcomes scores showed significant improvements for function, stiffness and pain at all points of follow-up. The total number of complications was 131 in 97 (42.2%) patients (48 by 2 months, 46 at 6 months and 32 at 1 year). Systemic complications comprised 41 of these, many being relatively minor. There were no deaths, 4 deep vein thromboses and 3 myocardial infarctions. The majority of complications (90) were local, including 2 patellar dislocations, 3 periprosthetic fractures, 3 peroneal nerve injuries, 2 ‘late’ patellar tendon ruptures and 1 patellar avascular necrosis, 9 wound hematomas, and a substantial rate of 21 superficial or deep wound infections.
Although patients experience significant improvement in function, activity and pain following TKAR, there is a considerable incidence of complications up to 1 year following TKAR. This is important in terms of resources, patient counseling and also in identifying and instituting preventive measures where possible in order to improve outcomes for these patients.
Correspondence should be addressed to: Tim Wilton, BASK, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
