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General Orthopaedics

A prospective study of revision total knee replacements at a mean follow up of 11 years

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Introduction

We aim to assess the functional outcome, patient perceived satisfaction and implant survival at a mean follow up of 13[10–16] years following revision knee replacement.

Patients and Methods

Between 1995 and 2001, 243 revision knee replacements were performed in 230 patients using Endolink [Link, Hamburg] or TC3 [Depuy, Leeds] prosthesis at Wrightington hospital, Wrightington, were consented to take part in this study. Data was collected prospectively which includes complications and functional assessment by Oxford knee score, WOMAC, HSS, UCLA, SF12 scores, and patient satisfaction questioner. The scores were obtained pre-operatively and post-operatively at 1 year, 5 years and at the latest follow-up. The mean age was 69 yrs, 51% were males, TC3 prosthesis as used in 175 and Endolink in 68, the revision was for Infection in 71[29%], 53 patients had intra-operative positive culture, 35 had 2 stage revision.

Results

At a mean follow up of 13 years [10–16] the survival of revision knee replacement in our patient group is 86%. Further surgery was performed in 35[14%], which includes 5 patients who had above knee amputation. The re-revision rate in the non-infected group [13%] was significantly lower compared to the re-revision in infected group [18%]. The Oxford scores improved at 1 year which continued to improve up to 5 years following which there was a gradual deterioration in the scores. There was no significant improvement in the generic HSQ, SF12 and UCLA scores following surgery. The functional scores improved to a lesser extent in patients with proven infection.

Discussion and Conclusion

At a mean follow up of 13 years the implant survival for revision knee replacement using endolink or TC3 prosthesis is 86%. The non-infected group had lower re-revision rates. The improvement in functional scores is lower following revision for infection.