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.

Introduction: Traumatic cauda equina constitutes a significant number of presentations of spinal cord injury in the emergency setting. Cauda equina syndrome from lumbar disc herniation accounts for up to 2–3% of all disc herniation. The aim of this study was to investigate and compare the success of surgical intervention between cauda equina that results from acute versus chronic pathology.

Patients and Methods: 47 patients who underwent surgery for cauda equina syndrome due to acute trauma or a herniated disc in the period between 2000 and 2006. All presented with one or more of the categorical symptoms associated with cauda equina (CE) syndrome such as sciatica, saddle hypoaesthesia, urinary incontinence and others. All patients had been catheterised at the time of admission to the National Spinal Unit. Patients presenting with acute CE underwent surgery within 24 hours. Patients presenting with chronic pathology underwent surgery within 48 hours. Differences in postoperative resolution of neurological function is compared between the two groups. The role of preoperative duration of symptoms in recovery of bladder function was examined.

Results: The follow-up ranged from 12–86 months. In 33 patients (70%) excellent results were achieved, in 8 patients (18%) good results were achieved and in 6 patients (10%) poor results were achieved. There was no statistically significant difference concerning the time between the onset of symptoms and surgical decompression. Significant difference appears to exist between the neurological recovery of those patients who underwent surgery subsequent to acute trauma in comparison to those with longer standing pathology.

Conclusion: Surgical intervention results in the resolution of neurological symptoms in those patients who present with symptoms consistent with cauda equina. This result is more apparent in those who presented with acute trauma.