Abstract
Aims
To map literature on prognostic factors related to outcomes of revision total knee arthroplasty (rTKA), to identify extensively studied factors and to guide future research into what domains need further exploration.
Methods
We performed a systematic literature search in MEDLINE, Embase, and Web of Science. The search string included multiple synonyms of the following keywords: "revision TKA", "outcome" and "prognostic factor". We searched for studies assessing the association between at least one prognostic factor and at least one outcome measure after rTKA surgery. Data on sample size, study design, prognostic factors, outcomes, and the direction of the association was extracted and included in an evidence map.
Results
After screening of 5,660 articles, we included 166 studies reporting prognostic factors for outcomes after rTKA, with a median sample size of 319 patients (30 to 303,867). Overall, 50% of the studies reported prospectively collected data, and 61% of the studies were performed in a single centre. In some studies, multiple associations were reported; 180 different prognostic factors were reported in these studies. The three most frequently studied prognostic factors were reason for revision (213 times), sex (125 times), and BMI (117 times). Studies focusing on functional scores and patient-reported outcome measures as prognostic factor for the outcome after surgery were limited (n = 42). The studies reported 154 different outcomes. The most commonly reported outcomes after rTKA were: re-revision (155 times), readmission (88 times), and reinfection (85 times). Only five studies included costs as outcome.
Conclusion
Outcomes and prognostic factors that are routinely registered as part of clinical practice (e.g. BMI, sex, complications) or in (inter)national registries are studied frequently. Studies on prognostic factors, such as functional and sociodemographic status, and outcomes as healthcare costs, cognitive and mental function, and psychosocial impact are scarce, while they have been shown to be important for patients with osteoarthritis.
Cite this article: Bone Jt Open 2023;4(5):338–356.
Take home message
Outcomes and prognostic factors that are routinely registered as part of clinical practice (e.g. BMI, sex, complications) or in (inter)national registries are studied frequently.
Significant gaps in literature (such as functional and sociodemographic status, and outcomes as healthcare costs and psychosocial impact) that were identified could guide future research with the overall goal to further our understanding of revision total knee arthroplasty and to improve outcome prediction.
Introduction
Revision total knee arthroplasty (rTKA) can be a complex procedure, which is illustrated by generally worse outcomes when compared to primary TKA1-5 Ideally, a good prediction model can help to identify the patients with increased risk of unfavourable outcomes. However, no valid prediction models exist for rTKA.6,7 Prediction models that have been developed for primary TKA could provide a good starting point, but have generally insufficient discriminative ability, and poor external validity.8 Making clinically relevant prediction models requires data that comprehensively cover multiple domains of both patient factors and outcomes.
An evidence map can provide valuable information to guide future research into what domains need further exploration, that eventually can help better understanding and prediction of outcome following rTKA. This map reflects which domains or topics are studied extensively, and which are understudied, thus reflecting the gaps of knowledge. Some prognostic factors and outcomes are easily accessible and acquired as they are part of routine registration (e.g. BMI and sex). Therefore, it is expected that the domains which are part of routine registration, in patient records or registries, are relatively well studied. On the other hand, there are likely a number of variables, identified by stakeholders as a relevant factor or outcome, that are more difficult to obtain. Relevant domains for patients with osteoarthritis (OA) have been previously identified by the International Consortium for Health Outcomes Measurement (ICHOM) and Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative and the Outcome Measures in Rheumatology (OMERACT-OARSI). They have developed standard sets of variables and outcomes that guide researchers and clinicians in the selection of variables important to patients with OA.9,10
In this study, we will perform a mapping review to provide an evidence map of the prognostic factors and outcome measures relevant for rTKA. The evidence map will be used to identify gaps of knowledge and identify factors and outcomes that have been more extensively studied. These findings can guide future research with the overall goal to further our understanding of rTKA and to improve outcome prediction.
Methods
Protocol and registration
We performed and reported a mapping review following the PRISMA guidelines for scoping reviews, as there is no alternative guideline for mapping reviews.11 The study protocol was registered at Open Science Framework.12
Eligibility criteria
We searched for studies assessing the association between at least one prognostic factor and at least one outcome measure after rTKA surgery. We included only articles written in English. The population of interest was patients who underwent a rTKA. We excluded reviews, case reports and studies not including humans (e.g. cadaver or animal studies). All preoperative prognostic variables (e.g. demographical, diagnostic, and psychological variables) reported in combination with any type of outcomes (e.g. clinical, patient-reported outcome measures (PROMs), or functional outcomes) were included.
Search strategy
To map the current literature, we carried out a systematic literature search from date of inception to December 2022 in MEDLINE, Embase, and Web of Science. The search strategy included multiple synonyms of the terms "rTKA" and "outcome" and "prognostic factor". The synonyms were searched in subject headings and words restricted to title and abstract, as detailed in our study protocol (Supplementary material i).12
Selection of sources of evidence
The search strategy was performed by one author (MB). Duplicates were removed from the results of the search strategy. The studies were screened in two phases. First, the titles and abstracts of all articles were screened for eligibility by two authors (MB, BR). Second, all full-text articles that were included on the basis of the abstract, were retrieved and evaluated on eligibility by the same two authors. In both steps, consensus was sought, but when no consensus could be reached, a third review author (KS) was consulted.
Data charting process and data items
Of the papers included in this review, we extracted data on publication date, journal, sample size, study design, prognostic factor(s), outcome measures, and the categories that were used for prognostic factors and/or outcome measures. Additionally, we noted the direction of the association between the prognostic factor and outcome measure. Associations that were reported as statistically significant, were defined as either a positive (e.g. more satisfied or less re-revisions) or a negative effect (e.g. more complications or worse functional scores). Non-significant associations were defined as non-significant. The direction of the effect was transformed so that the same reference category was used in all studies using that particular prognostic factor. For example, for sex, female was always used as reference group. Also, the absence of a specific comorbidity, patient or disease characteristic, and a low BMI, age, or American Society of Anaesthesiologists (ASA) score were used as a reference category.
Furthermore, we extracted data about the type of analysis that was used for testing the association, and whether it was corrected for confounding variables or not. In case of multivariate models, we also extracted how the independent variables were selected. Data was extracted by one author (MB). Next, the prognostic factors and outcomes were grouped in different categories to structure the results. Outcomes were grouped based on the OMERACT-OARSI core outcome domain set for hip and knee OA, consisting of the following domains: adverse events (including mortality), patient’s global assessment of target joint, quality of life, physical function, pain, joint structure (changes in joint structure on imaging), costs, sleep, psychosocial impact, participation, effect on family/caregivers, fatigue, cognitive function (covering both cognitive and mental functioning), and clinician global assessment of target joint.10 Prognostic factor categories were: case-mix factors (such as age and sex), comorbidity, functional status, indication for surgery, lab test, medical history, medical history knee specific, and patient-reported health status (or PROMs). The prognostic factor categories were based on the ICHOM standard set for hip or knee OA,9 extended with components of the preoperative screening, namely: indication for surgery, lab test, and medical history. An overview of all prognostic factors, outcomes, and their categories can be found in Supplementary Tables ii and iii.
Critical appraisal of individual sources of evidence
Given the nature of a mapping review, we did not assess the risk of bias of the included studies. We did extract information about the study design regarding the prospective or retrospective nature of data collection, and if the study was conducted in a single or multicentre set-up.
Synthesis of results
We used descriptive statistics to report the findings. R (version 4.1.3; R Foundation for Statistical Computing, Austria) was used to make a graphical overview of the literature using the ggplot2 package (version 3.3.5) and an online, interactive overview with the shiny package (version 1.7.1).13-15
Results
The literature search resulted in 6,548 articles after removing duplicates. An overview of the identification of studies can be found in Figure 1. After the full-text screening, a total of 166 studies assessing the association between prognostic factors and outcome measures after rTKA surgery were included in this review (Table I). In 50% of the studies, the data was collected prospectively, and the majority included patients from a single centre (61%; 101/166). The median sample size of the studies was 319 (30 to 303,867). In 98/166 of studies (59%), a multivariate model was used to study the association between the prognostic factors and the outcomes. In most studies (52%; 51/98), the covariates in the model were reported as a set of variables that the authors prespecified as confounders of the association between prognostic variable and the outcome. The other most common methods for variable selection were based on the p-value of univariate association (19%; 19/98 studies), or building the model using stepwise or backward selection based on the Akaike Information Criterion (AIC; 12%; 12/98 studies). In the other studies, propensity score matching or machine learning methods were used to select confounders, or methods for confounder selection were not reported.
Fig. 1
Flowchart of the literature search.
Table I.
Included literature.
| First author | Year | Sample size | Type study | Centre | Association | Covariable selection for multivariate models | Prognostic factors | Outcomes |
|---|---|---|---|---|---|---|---|---|
| Aali-Rezaie16 | 2018 | 1,344 | retrospective | single | multi | p-value univariate | red blood cell distribution width | complications, length of stay, mortality, readmission |
| Abram17 | 2021 | 40,854 | retrospective | multi | multi | set of covariables | age, sinus tract, BMI, Staphylococcus aureus, culture negative PJI | reinfection |
| Aggerwal18 | 2014 | 168 | prospective | single | multi | set of covariables | age, BMI, sex, infection | re-revision |
| Akkaya19 | 2022 | 66 | retrospective | single | uni | planned surgery | length of stay, consultation with health professional | |
| Apinyankul20 | 2022 | 238 | retrospective | single | multi | p-value univariate | reason for revision | complications, re-revision |
| Arndt21 | 2022 | 3,354 | retrospective | multi | uni | reason for revision, age, sex, Charlson comorbidity index, opioid use | opioid use | |
| Bae22 | 2013 | 224 | prospective | single | uni | age, sex, reason for revision | re-revision | |
| Baek23 | 2021 | 78 | retrospective | single | uni | age, sex, ethnicity, BMI, smoking, reason for revision, Charlson comorbidity index, ASA, diabetes mellitus, COPD, congestive heart failure, renal failure, metastatic cancer, bleeding disorders, wound infection | mortality | |
| Baker24 | 2012 | 797 | prospective | multi | uni | reason for revision | EQ-5D, OKS, satisfaction | |
| Barrack25 | 2002 | 135 | prospective | multi | multi | stepwise selection | prior surgery, heterotopic ossification, BMI, sex, reason for revision | heterotopic ossification, KSS, ROM |
| Bass26 | 2021 | 25441 | prospective | multi | multi | set of covariables | age, cancer, cerebrovascular disease, COPD, BMI, diabetes mellitus, ethnicity, heart failure, sex, history of VTE, inflammatory bowel disease, pulmonary hypertension, renal disease, rheumatoid arthritis, sleep apnoea, smoking, reason for revision, systemic lupus, thrombophilia, venous insufficiency | venous thromboembolism |
| Bedard27 | 2018 | 8,776 | prospective | multi | multi | unknown | smoking | complications, infection, mortality, reoperation |
| Belmont28 | 2016 | 1,754 | prospective | multi | uni | hypertension, cerebrovascular accident, sex | readmission | |
| Belt29 | 2021 | 8,978 | prospective | multi | uni | reason for revision | reinfection, re-revision | |
| Bieger30 | 2013 | 97 | prospective | single | uni | reason for revision | KSS | |
| Boddapati31 | 2018 | 12,780 | prospective | multi | multi | set of covariables | age, PJI, ASA, COPD, diabetes mellitus, smoking, BMI, sex | complications, blood transfusion, cardiac complications, readmission, cerebrovascular accident, deep surgical site infection, deep venous thrombosis, sepsis, length of stay, major complications, minor complications, mortality, non-home discharge, renal complications, urinary tract infection, wound dehiscence, respiratory complication, superficial surgical site infection |
| Carter32 | 2019 | 237 | retrospective | single | uni | BMI | amputation, aseptic loosening, ICU admission, infection, manipulation under anaesthesia, mortality, wound complications | |
| Chalmers33 | 2019 | 135 | retrospective | single | multi | set of covariables | age, BMI, sex, prior revision, reason for revision | re-revision, re-revision for instability, re-revision for loosening |
| Chalmers34 | 2021 | 197 | retrospective | single | multi | set of covariables | BMI, sex, prior revision, reason for revision | re-revision |
| Chalmers35 | 2021 | 163 | retrospective | single | multi | set of covariables | reason for revision | OKS, EQ-VAS, EQ-5D, KSS, ROM |
| Chen36 | 2020 | 58 | retrospective | single | multi | p-value univariate | BMI, anaerobic pathogens, cirrhosis, CRP, polymicrobial infection, virulent pathogens | reinfection |
| Chen37 | 2021 | 172 | retrospective | single | uni | chronic viral hepatitis | infection, re-revision | |
| Choi38 | 2014 | 176 | prospective | single | multi | set of covariables | age, BMI, ASA, comorbidity, MRSA, sex, reason for revision | mortality |
| Christiner39 | 2022 | 144 | retrospective | single | uni | sex, anticoagulant use, prior DAIR, smoking, sinus tract, BMI, ASA | infection | |
| Chung1 | 2021 | 13,597 | retrospective | multi | multi | set of covariables | coagulation | transfusion, cardiac arrest, myocardial infarction, pneumonia, reintubation, renal insufficiency |
| Churchill40 | 2021 | 1,676 | prospective | multi | multi | unknown | coagulation, age, ASA, bleeding disorders, blood urea nitrogen, BMI, Charlson comorbidity index, congestive heart failure, COPD, creatinine, diabetes mellitus, ethnicity, hypertension, smoking, sex | acute renal failure, length of stay, pneumonia, cerebrovascular accident, deep venous thrombosis, transfusion, sepsis, infection, unplanned intubation, wound disruption, urinary tract infection, mortality, myocardial infarction, on ventilator, pulmonary embolism, readmission, renal insufficiency, return to OR, septic shock, superficial surgical site infection, surgical site infection |
| Citak41 | 2019 | 183 | retrospective | single | uni | age, depression, BMI, deep venous thrombosis, sex, polymicrobial infection, prior surgery, weight, Charlson comorbidity index, COPD, coronary heart disease, CRP, dementia, diabetes mellitus, haemoglobin, liver disease, prior arthroscopy, renal failure, rheumatoid arthritis, tumour history, white blood cell count | re-revision, reinfection | |
| Cochrane42 | 2022 | 21,610 | retrospective | multi | uni | age, sex, ethnicity, BMI, smoking, ASA, functional status, DM insulin dep, DM non-insulin dep, COPD, heart failure, liver disease, hypertension, renal failure, dialysis, cancer, steroid use, bleeding disorders | length of stay | |
| Cochrane43 | 2022 | 157 | retrospective | single | multi | set of covariables | BMI, diabetes mellitus, anaemia, smoking | postoperative infection |
| Cohen44 | 2019 | 8,559 | prospective | multi | uni | Glomerular Filtration Rate | cardiac arrest, complications, death, deep venous thrombosis, deep wound infection, prolonged length of stay, fail to wean, myocardial infarction, organ infection, pneumonia, pulmonary embolism, reintubation, renal failure, wound dehiscence, urinary tract infection, renal insufficiency, return to OR, sepsis, septic shock, cerebrovascular accident, superficial surgical site infection | |
| Courtney45 | 2018 | 10,848 | prospective | multi | multi | set of covariables | reason for revision | cardiac arrest, complications, cerebrovascular accident, deep venous thrombosis, fail to wean, infection, mortality, myocardial infarction, pneumonia, pulmonary embolism, readmission, reintubation, renal failure, renal insufficiency, reoperation, sepsis, septic shock |
| Dahlgren46 | 2018 | 171 | retrospective | single | uni | age, BMI, albumin, ASA, bleeding disorders, COPD, diabetes mellitus, dialysis, dyspnoea on exertion, ethnicity, packed cell volume, hypertension, International Normalized Ratio, platelet count, serum creatinine, smoking, steroid use, white blood cell count, sex | readmission | |
| Dai47 | 2021 | 32,349 | prospective | multi | multi | propensity score matched | reason for revision | anaemia, blood transfusion, cardiac complications, central nervous system, complications, costs, deep venous thrombosis, gastrointestinal complication, haematoma, length of stay, mortality, postoperative infection, pulmonary embolism, respiratory complication, urinary system complication, vascular complication, wound dehiscence |
| de Carvalho48 | 2015 | 30 | retrospective | single | uni | BMI, reason for revision | WOMAC | |
| Deehan49 | 2006 | 94 | prospective | single | uni | prior revision | KSS | |
| Deere50 | 2021 | 33,292 | prospective | multi | uni | age, sex, prior revision | re-revision | |
| DeMik51 | 2022 | 22,262 | retrospective | multi | multi | p-value univariate | transfusion pre-op, packed cell volume, bleeding disorders, COPD | blood transfusion |
| Dieterich52 | 2014 | 3,421 | prospective | multi | multi | p-value univariate | age, ASA, dialysis, emergency operation, pulmonary disease, sex | complications |
| Dowdle53 | 2018 | 5,414 | prospective | multi | multi | set of covariables | age, anxiety, depression, BMI, diabetes mellitus, smoking, sex, opioid use | manipulation under anaesthesia |
| Drain54 | 2022 | 222 | retrospective | multi | uni | reason for revision | mortality, Charlson comorbidity index, mortality related to infection, mortality related to comorbidities, mortality due to myocardial infarction, mortality due to cerebrovascular event, mortality due to congestive heart failure, mortality due to pulmonary embolism, mortality due to liver failure, mortality due to respiratory failure, mortality due to renal failure, mortality due to cancer, mortality due to sepsis, mortality due to systemic inflammatory response syndrome, mortality due to multiple causes | |
| Edmiston2 | 2019 | 14,486 | retrospective | multi | multi | set of covariables | BMI, sex, AIDS, alcohol abuse, anaemia, cardiac arrhythmia, chronic pulmonary disease, bleeding disorders, congestive heart failure, connective tissue disorder, dementia, diabetes mellitus, fluid electrolyte disorder, lymphoma, metastatic cancer, peripheral vascular disease, renal failure, weight loss | surgical site infection |
| Faschingbauer55 | 2020 | 96 | retrospective | single | uni | alcohol abuse, COPD, diabetes mellitus, heart failure, hypertension, renal failure, malignancies, rheumatoid arthritis, smoking | reinfection | |
| Fassihi56 | 2020 | 10,973 | retrospective | multi | multi | p-value univariate | steroid use | length of stay, mortality, septic shock |
| Fleischman57 | 2017 | 223 | prospective | single | multi | backward selection | age, BMI, sex, reason for revision | re-revision |
| Fury58 | 2021 | 213 | retrospective | single | uni | reason for revision | re-revision | |
| Gao59 | 2019 | 260 | retrospective | single | multi | set of covariables | surgical history | re-revision |
| Geary60 | 2020 | 1,632 | retrospective | single | multi | unknown | age, sex, reason for revision | re-revision |
| Ghanem61 | 2007 | 93 | prospective | single | multi | set of covariables | reason for revision | pain, SF-36 mental health, SF-36 physical, WOMAC function |
| Ghomrawi62 | 2009 | 308 | prospective | multi | multi | set of covariables | age, BMI, comorbidity, extension contracture, sex, flexion contracture, reason for revision | pain, SF-36, Lower-Extremity Activity Scale (LEAS), WOMAC function |
| Goh63 | 2021 | 245 | prospective | single | multi | set of covariables | age, BMI, Charlson comorbidity index, sex, reason for revision, SF-36 MCS | expectations, satisfaction |
| Grayson64 | 2016 | 177 | prospective | single | uni | reason for revision | KSS clinical, KSS function, satisfaction, UCLA | |
| Gu65 | 2018 | 9,921 | prospective | multi | multi | p-value univariate | age, COPD, BMI, ASA, diabetes mellitus, sex | length of stay, complications, reoperation, mortality |
| Gu66 | 2020 | 13,246 | prospective | multi | uni | DM insulin dep, DM non-insulin dep | cardiac arrest, death, deep surgical site infection, deep venous thrombosis, fail to wean, length of stay, myocardial infarction, organ infection, pneumonia, wound dehiscence, pulmonary embolism, urinary tract infection, transfusion, reintubation, renal failure, renal insufficiency, return to OR, sepsis, septic shock, cerebrovascular accident, superficial surgical site infection | |
| Gu67 | 2021 | 13,313 | prospective | multi | multi | p-value univariate | anaemia | bleeding, cardiac complications, complications, wound complications, urinary tract infection, length of stay, mortality, pulmonary complications, renal complications, return to OR, septic shock, thromboembolic event |
| Gu68 | 2019 | 6,849 | prospective | multi | multi | p-value univariate | blood transfusion | deep venous thrombosis, unplanned intubation, transfusion, fail to wean, myocardial infarction, organ infection, pneumonia, readmission, sepsis, septic shock |
| Gu69 | 2020 | 9,914 | prospective | multi | multi | age, ASA, bleeding disorders, blood transfusion, diabetes mellitus, dyspnoea, ethnicity, functional status, renal failure, BMI, sex, COPD | prolonged length of stay, return to OR, cardiac arrest, complications, deep venous thrombosis, deep wound infection, fail to wean, mortality, myocardial infarction, organ surgical site infection, pneumonia, pulmonary embolism, reintubation, renal failure, renal insufficiency, sepsis, septic shock, cerebrovascular accident, superficial surgical site infection, urinary tract infection, wound dehiscence | |
| Hagerty70 | 2021 | 615 | retrospective | single | multi | set of covariables | type of infection | reinfection |
| Halder71 | 2020 | 23,664 | prospective | multi | multi | set of covariables | hospital volume | adverse events, mortality, re-revision |
| Hamaway72 | 2022 | 106,534 | retrospective | multi | uni | age, Charlson comorbidity index, BMI, ASA, reason for revision, renal disease, anaemia, diabetes mellitus, sex, smoking | prolonged length of stay | |
| Hannon73 | 2022 | 60 | retrospective | single | uni | age, sex, BMI | re-revision | |
| Hardcastle74 | 2016 | 228 | retrospective | single | uni | elevated CRP / ESR | aseptic loosening, instability, infection, fracture, re-revision | |
| Hardeman75 | 2012 | 146 | prospective | single | uni | age, tibial tuberositas osteotomy, time to revision, reason for revision | KSS clinical, KSS function, pain, re-revision | |
| Heesterbeek76 | 2016 | 40 | prospective | single | uni | ROM | KSS function, pain, satisfaction | |
| Hernigou77 | 2017 | 72 | retrospective | single | multi | set of covariables | primary diagnosis, reason for revision | KSS clinical, KSS function, re-revision, ROM, satisfaction |
| Hoell78 | 2016 | 59 | retrospective | single | uni | BMI, blood transfusion, diabetes mellitus, periprosthetic fracture, smoking, tumour | reinfection | |
| Ingall79 | 2021 | 330 | prospective | single | uni | propensity score matched | opioid use | KOOS-PS, PROMIS physical, PROMIS mental, Physical Function SF10A |
| Jannelli80 | 2022 | 105 | retrospective | single | uni | iron deficiency | length of stay, costs, acute renal injury, pneumonia, respiratory failure, ileus episode, urinary tract infection, myocardial infarction, cerebrovascular accident, deep venous thrombosis, surgical site infection, venous thromboembolism, pulmonary embolism, complications | |
| Jeschke81 | 2022 | 34,643 | retrospective | multi | multi | set of covariables | age, sex, BMI, fluid electrolyte disorder, cardiac arrhythmia, renal failure, congestive heart failure, valvular disease, bleeding disorders, neurological disease, alcohol abuse, drug abuse, psychoses, pulmonary circulation disorder, prior revision, anticoagulant use | blood transfusion |
| Kamath82 | 2017 | 4,551 | prospective | multi | multi | albumin | acute renal failure, cardiac arrest, cardiac pulmonary complication, complications, wound disruption, unplanned intubation, urinary tract infection, transfusion, wound infection, cerebrovascular accident, deep surgical site infection, deep venous thrombosis, mortality, myocardial infarction, on ventilator, organ surgical site infection, pneumonia, pulmonary embolism, renal insufficiency, sepsis, septic shock, superficial surgical site infection, systemic infection | |
| Kasmire83 | 2014 | 175 | prospective | single | multi | set of covariables | BMI, sex, comorbidity, KSS function, KSS clinical, pain, stiffness | stiffness, WOMAC function, KSS function, pain |
| Keswani84 | 2016 | 4,977 | prospective | multi | multi | p-value univariate | age, BMI, ASA, cardiac disease, diabetes mellitus, ethnicity, hypertension, renal disease, pulmonary disease, smoking, cerebrovascular accident, sex, reason for revision | readmission |
| Kienzle85 | 2020 | 100 | retrospective | single | uni | prior revision, ASA, sex | aseptic loosening, complications, infection | |
| Kildow86 | 2022 | 178 | retrospective | multi | uni | polymicrobial infection, antibiotic resistant organism, sex, prior two-stage revision, diabetes mellitus, chronic renal disease, coronary vascular disease, myocardial infarction, congestive heart failure, deep venous thrombosis, smoking, former smoking, systemic disease, chronic lung disease | reinfection | |
| Kim87 | 2010 | 807 | prospective | single | multi | set of covariables | age, BMI, sex, ROM, time to revision, reason for revision | stiffness |
| Kim88 | 2019 | 77 | prospective | single | multi | backward selection | central sensitization | satisfaction, pain, stiffness, WOMAC function |
| Kingsbury89 | 2022 | 263 | prospective | multi | multi | propensity score matched | age, sex, primary diagnosis, index of multiple deprivation, reason for revision, elixhauser comorbidity index | mortality |
| Kirschbaum90 | 2022 | 63 | retrospective | single | uni | reason for revision, BMI, sex, age | re-revision | |
| Klasan91 | 2020 | 1,720 | prospective | multi | multi | p-value univariate | age, sex, ASA, time to revision | re-revision, OKS |
| Klasan92 | 2021 | 633 | retrospective | single | multi | set of covariables | obesity, smoking, diabetes mellitus | reoperation, re-revision, amputation above knee, infection, extensor mechanism failure, ligamentous laxity, malposition, stiffness |
| Klemt93 | 2022 | 2,228 | retrospective | single | multi | recursive feature elimination through random forest algorithms | diabetes mellitus, opioid use, sex, age, social status, ethnicity, reason for revision, insurance status, ASA | non-home discharge |
| Klemt94 | 2022 | 2,512 | retrospective | single | multi | artificial intelligence, best predictors | ||
| Kubista95 | 2011 | 368 | retrospective | single | multi | backward selection | age, BMI, sex, comorbidity, diabetes mellitus, type of infection, rheumatoid arthritis | reinfection |
| Kurd96 | 2010 | 102 | prospective | single | uni | age, BMI, ASA, sex, DAIR, diabetes mellitus, type of infection, smoking, steroid use | reinfection | |
| Labaran97 | 2020 | 18,359 | prospective | multi | multi | set of covariables | haemodialysis-dependent | complications, infection, length of stay, mortality, readmission, costs, septicaemia |
| Labaran98 | 2020 | 7,459 | retrospective | multi | multi | renal transplant | infection, length of stay, major complications, mortality, readmission, septicaemia | |
| Larson99 | 2021 | 110 | retrospective | single | multi | set of covariables | reason for revision, sex, age, Charlson comorbidity index, obesity, index of multiple deprivation, geographical rurality, ethnicity | mortality |
| Laudermilch100 | 2010 | 103 | retrospective | single | uni | MRSA | activity of daily living limitation, SF-36, KSS clinical, KSS function, WOMAC | |
| Lee101 | 2017 | 206 | retrospective | single | uni | reason for revision | Hospital for Special Surgery score (HSS), KSS, ROM, WOMAC | |
| Lee102 | 2020 | 16,428 | prospective | multi | multi | p-value univariate | DM insulin dep, DM non-insulin dep | blood transfusion, cerebrovascular accident, death, deep surgical site infection, deep venous thrombosis, prolonged length of stay, myocardial infarction, pneumonia, unplanned intubation, urinary tract infection, pulmonary embolism, readmission, renal failure, renal insufficiency, return to OR, sepsis, superficial surgical site infection |
| Lee103 | 2020 | 5,204 | prospective | multi | multi | chronic renal disease | acute renal failure, blood transfusion, cardiac arrest, cerebrovascular accident, deep surgical site infection, deep venous thrombosis, prolonged length of stay, wound disruption, unplanned intubation, ventilator dependence, urinary tract infection, length of stay, mortality, myocardial infarction, organ surgical site infection, pneumonia, pulmonary embolism, renal insufficiency, return to OR, septic shock, superficial surgical site infection, non-home discharge, systemic sepsis | |
| Leta104 | 2015 | 145 | prospective | multi | multi | set of covariables | age, sex, patella resurfacing | re-revision |
| Liang105 | 2018 | 224 | retrospective | single | uni | age, sex, primary diagnosis | re-revision | |
| Lindberg-Larsen106 | 2022 | 3,118 | retrospective | single | multi | set of covariables | prior revision, walking aid, BMI, haemoglobin, cardiac disease, pulmonary disease, psychiatric disorder pharmacologically treated, DM insulin dep, age, sex, elixhauser comorbidity index, hospital volume | length of stay, readmission, mortality |
| Liodakis107 | 2015 | 2,425 | prospective | multi | multi | AIC | age, BMI, ASA, bleeding disorders, COPD, diabetes mellitus, heart failure, packed cell volume, hypertension, smoking, sex | major complications, prolonged length of stay |
| Lopez-de-Andres108 | 2017 | 1,390 | prospective | multi | uni | diabetes mellitus, hypertension, smoking, BMI, reason for revision | anaemia, cardiac complications, central nervous system, complications, deep venous thrombosis, gastrointestinal complication, genitourinary complications, haematoma, infection, length of stay, mortality, peripheral vascular disease, wound dehiscence, urinary tract infection, pulmonary embolism, renal failure, respiratory complication, septic shock | |
| Lu109 | 2017 | 6,830 | prospective | multi | multi | p-value univariate | anaemia | complications, length of stay, mortality, readmission |
| Luque110 | 2014 | 125 | retrospective | single | multi | p-value univariate | age, renal failure, rheumatoid arthritis, tibial tuberositas osteotomy, reason for revision | re-revision |
| Ma111 | 2018 | 108 | retrospective | single | multi | p-value univariate | ASA, age, BMI, sex, gout | treatment success |
| Mahomed112 | 2005 | 11,726 | prospective | multi | uni | age, comorbidity, ethnicity, sex, Medicaid | complications, mortality, reoperation | |
| Malviya113 | 2012 | 120 | prospective | single | multi | set of covariables | age, BMI, reason for revision | WOMAC, satisfaction, SF-36 |
| Malviya114 | 2012 | 120 | prospective | single | multi | set of covariables | age, BMI, sex, comorbidity, reason for revision | SF-36 bodily pain, SF-36 physical, WOMAC function, WOMAC pain |
| Massin115 | 2016 | 285 | retrospective | multi | multi | p-value univariate | age, BMI, sex, diabetes mellitus, pathogen, prior infection | reinfection |
| Matar116 | 2021 | 1,298 | retrospective | single | multi | set of covariables | reason for revision | mortality |
| Matar117 | 2021 | 292 | prospective | single | multi | forward selection | age, sex, haemoglobin, ASA, arterial hypertension, anticoagulant use, myocardial infarction, chronic heart disease, diabetes mellitus, chronic renal disease, COPD, BMI | blood loss |
| Meyer118 | 2021 | 235 | retrospective | multi | uni | age, sex, reason for revision | re-revision | |
| Mortazavi119 | 2011 | 499 | prospective | single | uni | age, BMI, bilateral, cancer, comorbidity, diabetes mellitus, gastrointestinal disease, cardiac disease, inflammatory arthritis, liver disease, renal disease, cerebrovascular accident, thyroid disease, vascular arterial disease, vascular venous disease, sex, reason for revision | infection, re-revision | |
| Mulhall120 | 2007 | 291 | prospective | multi | multi | set of covariables | BMI | Lower-Extremity Activity Scale (LEAS), KSS, re-revision, WOMAC function, WOMAC pain |
| Nikolaus121 | 2016 | 1,802 | retrospective | single | uni | age, BMI, ASA, comorbidity, liver disease, smoking, sex | infection | |
| Novicoff122 | 2009 | 308 | retrospective | multi | uni | low back pain | Lower-Extremity Activity Scale (LEAS), SF-36, KSS, WOMAC clinical, WOMAC function | |
| Oganesyan123 | 2021 | 1,689 | retrospective | single | uni | prior arthroscopy | mortality, readmission, re-revision, re-revision for aseptic loosening, re-revision for infection, re-revision for instability, re-revision for pain, re-revision for stiffness | |
| Patil124 | 2009 | 56 | prospective | single | multi | set of covariables | reason for revision | KSS, satisfaction, SF-36 mental health, SF-36 physical |
| Piuzzi125 | 2020 | 246 | prospective | single | multi | age, BMI, ethnicity, sex, pain, prior surgery, reason for revision, ROM, smoking | pain, KOOS quality of life, KOOS-PS, VR-12 MCS, VR-12 PCS | |
| Pun126 | 2008 | 67 | retrospective | single | uni | sex, reason for revision | KSS, pain | |
| Quinn127 | 2022 | 202 | retrospective | single | uni | sex, age, weight, BMI, reason for revision, prior revision, ROM | OKS, ROM | |
| Rajgopal128 | 2018 | 184 | retrospective | single | uni | failed DAIR | KSS, time to re-revision, re-revision, ROM, re-revision for infection | |
| Rajgopal129 | 2013 | 142 | retrospective | single | uni | reason for revision | re-revision, ROM | |
| Reeves130 | 2018 | 46,836 | prospective | multi | uni | reason for revision | length of stay, mortality, readmission | |
| Ritter131 | 2004 | 355 | prospective | single | uni | age, preoperative alignment, preoperative flexion, sex | flexion, extension | |
| Ro132 | 2018 | 144 | retrospective | single | multi | stepwise selection | age, primary diagnosis, ROM, BMI, sex, reason for revision | Hospital for Special Surgery score (HSS), KSS clinical, KSS function, ROM |
| Ross133 | 2022 | 51,548 | retrospective | multi | multi | unknown | hepatitis C, reason for revision | any medical complication, deep venous thrombosis, pulmonary embolism, acute renal injury, urinary tract infection, transfusion, readmission, complications, manipulation under anaesthesia, re-revision, periprosthetic joint infection, aseptic loosening, periprosthetic fracture |
| Rossmann134 | 2021 | 40 | retrospective | single | uni | age, sex | reinfection | |
| Roth135 | 2019 | 9,773 | prospective | multi | multi | set of covariables | BMI | adverse events, major complications, minor complications, readmission, reoperation |
| Russo136 | 2022 | 108 | retrospective | single | multi | set of covariables | reason for revision, organ transplant | length of stay, readmission, re-revision, mortality |
| Sabah137 | 2021 | 10,329 | prospective | multi | multi | backward selection | age, disability, EQ-5D 3 L anxiety/depression, EQ-5D 3 L self-care, OKS | OKS change |
| Sabry138 | 2014 | 3,809 | retrospective | single | multi | p-value univariate | ASA, diabetes mellitus, preoperative antibiotics, prior infection, sex, prior surgery | infection, reinfection |
| Sakellariou139 | 2015 | 110 | prospective | single | multi | backward selection | age, BMI, ASA, sex, comorbidity, MRSA | reinfection |
| Samuel140 | 2020 | 3,531 | retrospective | multi | multi | unknown | age, sex, BMI, smoking, ASA, prior surgery, CRP, type of infection | re-revision |
| Schairer141 | 2014 | 1,408 | retrospective | single | multi | stepwise selection | reason for revision | readmission |
| Schwarze142 | 2022 | 157 | retrospective | single | uni | positive cultures | re-revision | |
| Shen143 | 2022 | 414 | retrospective | multi | uni | KSS function, ROM, coronal deviation, tibial malrotation, age, pain | KSS function | |
| Sheng144 | 2006 | 2,637 | prospective | multi | multi | p-value univariate | age, sex, primary diagnosis, time to revision, reason for revision | re-revision |
| Sinclair145 | 2021 | 32,354 | retrospective | multi | uni | age, sex, BMI, vascular disease, hypertension, diabetes mellitus, malignancy, renal failure, CRP, causative pathogen | readmission | |
| Singh146 | 2014 | 1,533 | prospective | single | multi | set of covariables | comorbidity, anxiety, depression | knee function |
| Singh147 | 2013 | 4,090 | prospective | single | multi | set of covariables | age, ASA, BMI, comorbidity, sex, reason for revision | periprosthetic fracture |
| Singh148 | 2011 | 2,695 | prospective | single | multi | age, BMI, comorbidity, sex | pain | |
| Singh149 | 2013 | 725 | prospective | single | multi | set of covariables | ipsilateral hip involvement | activity of daily living limitation, pain |
| Singh150 | 2013 | 1,533 | prospective | single | multi | set of covariables | connective tissue disorder, COPD, diabetes mellitus, cardiac disease, peripheral vascular disease, anxiety, renal disease, depression | pain |
| Singh151 | 2010 | 1,533 | prospective | single | multi | set of covariables | age, comorbidity, BMI, sex | walking aids, activity of daily living limitation |
| Singh152 | 2014 | 1,533 | prospective | single | multi | set of covariables | comorbidity, age, BMI, anxiety, depression, sex | narcotic pain medication, NSAIDs |
| Singh153 | 2014 | 1,533 | prospective | single | multi | set of covariables | reason for revision | activity of daily living limitation, pain |
| Siqueira154 | 2017 | 438 | retrospective | single | uni | reason for revision | re-revision | |
| Sisko155 | 2019 | 174 | prospective | single | uni | BMI | deep infection, KSS, reoperation, re-revision, SF-12, WOMAC | |
| Sloan156 | 2019 | 15,286 | prospective | multi | multi | set of covariables | BMI | deep venous thrombosis, pulmonary embolism |
| Sodhi157 | 2020 | 28,779 | prospective | multi | multi | set of covariables | depression, BMI, sex, opioid use, alcohol abuse, cannabis abuse, bleeding disorders, congestive heart failure, diabetes mellitus, electrolyte imbalance, hypertension, hypothyroidism, iron deficiency, peptic ulcer, renal failure, rheumatoid arthritis, sleep apnoea | surgical site infection |
| Staats158 | 2017 | 98 | retrospective | single | uni | positive minor criteria for PJI | re-revision | |
| Sternheim159 | 2012 | 102 | retrospective | single | uni | reason for revision | KSS clinical, KSS function, narcotic pain medication, pain, ROM | |
| Suarez160 | 2008 | 566 | retrospective | single | uni | age, reason for revision | re-revision | |
| Theil161 | 2022 | 119 | retrospective | single | uni | reason for revision, prior revision | re-revision | |
| Traven162 | 2019 | 16,304 | prospective | multi | multi | set of covariables | frailty | complications, mortality, readmission, non-home discharge |
| Turnbull163 | 2019 | 112 | retrospective | single | multi | p-value univariate | age, sex, OKS, prior revision, social deprivation Scottish index of multiple deprivation, reason for revision, UCLA activity | OKS, UCLA |
| Upfill-Brown164 | 2022 | 303,867 | retrospective | multi | uni | age, sex | pain | |
| van den Kieboom165 | 2021 | 79 | retrospective | single | uni | age, BMI, ASA, sex, smoking, alcohol use, drug use, renal disease, cardiovascular disease, hypertension, diabetes mellitus, malignant tumour, inflammatory disease, depression, haematological disease, neurological disease, pulmonary disease | re-revision | |
| van Kempen166 | 2013 | 150 | prospective | single | uni | reason for revision | complications, KSS clinical, KSS function, pain, ROM, satisfaction | |
| van Laarhoven167 | 2022 | 100 | prospective | single | multi | backward selection | age, sex, BMI, reason for revision | reoperation |
| van Rensch168 | 2020 | 129 | prospective | single | uni | mixed model | reason for revision | KSS clinical, KSS function, pain, ROM, satisfaction |
| Verbeek169 | 2019 | 295 | retrospective | single | multi | backward selection | age, sex, KSS function, reason for revision | KSS function |
| Wang170 | 2004 | 48 | prospective | single | uni | reason for revision | KSS, pain, ROM, SF-12 | |
| Watts171 | 2014 | 111 | prospective | single | multi | one confounder | age, BMI, sex, DAIR, diabetes mellitus, negative culture, rheumatoid arthritis, smoking | reinfection, reoperation, re-revision |
| Watts172 | 2015 | 186 | prospective | single | multi | one confounder | BMI | KSS function, pain, periprosthetic joint infection, reoperation, re-revision |
| Wilson173 | 2020 | 13,973 | retrospective | multi | multi | set of covariables | depression | emergency department visit, prolonged length of stay, infection, wound complications, pain related ED visit, periprosthetic joint infection, readmission, re-revision, sepsis, thromboembolic event, costs, opioid use, non-home discharge |
| Wilson174 | 2020 | 11,786 | retrospective | multi | multi | set of covariables | opioid use | emergency department visit, prolonged length of stay, opioid overdose, infection, pain related ED visit, periprosthetic joint infection, readmission, wound complications, re-revision, sepsis, thromboembolic event, non-home discharge |
| Winther175 | 2022 | 178 | prospective | single | uni | reason for revision | pain during mobilization, pain at rest, KOOS-PS, KSS, EQ-5D | |
| Xiong176 | 2021 | 197 | retrospective | single | uni | reason for revision | extension deficit, flexion, pain, ROM, stiffness | |
| Xu177 | 2019 | 1224 | prospective | single | multi | set of covariables | sinus tract | mortality, treatment failure |
| Yapp178 | 2021 | 8,894 | prospective | multi | multi | set of covariables | age, sex, comorbidity, hospital volume, reason for revision | re-revision |
| Yapp179 | 2022 | 8,343 | retrospective | multi | multi | set of covariables | reason for revision | mortality, KSS clinical, KSS function, Koval grade |
-
ASA, American Society of Anaesthesiologists; COPD, chronic obstructive pulmonary disease; DAIR, debridement, antibiotics, and implant retention; DM, diabetes mellitus; EQ-5D, EuroQol five-dimension; EQ-5D EQ-5D-3L, EuroQol five-imension three-level; EQ-VAS, EuroQol visual analogue scale; ICU, intensive care unit; KOOS-PS, Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form; KSS, Knee Society Score; VR-12 MCS, Veterans rand 12 item mental health component summary; MRSA, methicillin-resistant Staphylococcus aureus; NSAID, non-steroidal anti-inflammatory drug; OKS, Oxford Knee Score; OR, operating room; VR-12 PCS, Veterans Rand 12 item physical health component summary; PJI, periprosthetic joint infection; PROMIS, Patient-Reported Outcomes Measurement Information System; ROM, range of motion; SF-36, 36-Item Short Form Survey; UCLA, University of California at Los Angeles; VTE, venous thromboembolism; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.
Prognostic factors of rTKA
A total of 180 different prognostic factors were found in the included studies. The three most frequently reported prognostic factors were reason for revision, sex, and BMI. Reason for revision was described 213 times in 68/166 studies (41%), sex 125 times in 76/166 studies (46%), and BMI 117 times in 64/166 studies (38%). Studies focusing on functional scores and PROMs as prognostic factor for the outcome after surgery were limited (n = 42). The prognostic factors that were most frequently reported to have a statistically significant association with the outcomes of rTKA, either positive or negative, were reason for revision, age, sex, BMI, and opioid use. Prognostic factors that are recommended by ICHOM, but have not been described in the included literature were education level, living condition, and work status.
Outcomes of rTKA
The studies reported 154 different outcomes. The most frequently used outcome category was adverse events, of which the majority of the studies reported re-revision, readmission, and reinfection after rTKA. Re-revision was described 155 times in 46/166 studies (28%), readmission 88 times in 23/166 studies (14%), and reinfection 85 times in 15/166 studies (9%). Costs, psychosocial impact, and quality of life outcomes were scarce. Only five studies included costs as outcome; in four out of five studies, this was limited to direct in-hospital costs of the surgery. Four studies included cognitive and mental function as outcome, measured using Patient-Reported Outcomes Measurement Information System (PROMIS) mental score, 36-Item Short Form Survey (SF-36) mental health, and Veterans RAND 12 Item Health Survey (VR-12) Mental Component Summary (MCS). In all, 17 studies used the 12-Item Short Form Survey (SF-12), SF-36, EuroQol five-dimension (EQ-5D), or Knee injury and Osteoarthritis Outcome Score quality of life subscale (KOOS-QoL) to assess quality of life after rTKA. Outcome categories recommended in the OMERACT-OARSI set that were not described in the included studies were joint structure, sleep, psychosocial impact, effect on family/caregiver, fatigue, and clinician global assessment of target joint.
Associations between prognostic factor and outcome
A graphical overview of all studied combinations of prognostic factors and different outcome measures is presented in Figure 2. There is also an interactive version of the plot.180
Fig. 2
Bubble plot of associations reported in the included studies.
The combinations of prognostic factor and outcome categories that were studied most often were comorbidities with adverse events (402 times reported in 54 studies), case-mix factors with adverse events (368 times reported in 79 studies), and indication of surgery with adverse events (160 times reported in 62 studies; Table II). The association between prognostic factors measuring functional status or PROMs with any type of outcomes after rTKA were the least frequently studied combination. Associations that were most frequently reported as statistically significant, either a positive or negative effect, were age and re-revision (12 times reported positive, one time reported negative, and eight times reported non-significant), reason for revision and re-revision (13 times reported negative, eight times reported non-significant), and reason for revision and mortality (nine times reported negative, one time reported non-significant).
Table II.
Number of times a combination of prognostic factor, and outcome is reported (number of unique studies).
| Prognostic factor categories | Outcome categories | ||||||||
| Adverse event | Physical function | Pain | Participation | Patients global assessment of target joint | Quality of life | Cognitive function | Costs | Total | |
| Case-mix | 368 (79) | 60 (20) | 39 (11) | 22 (7) | 6 (1) | 4 (2) | 1 (1) | 0 (0) | 500 (102) |
| Comorbidities | 402 (54) | 7 (6) | 13 (6) | 8 (5) | 2 (1) | 1 (1) | 0 (0) | 2 (1) | 435 (66) |
| Indication surgery | 160 (62) | 63 (30) | 22 (14) | 9 (6) | 10 (8) | 11 (8) | 3 (3) | 1 (1) | 279 (92) |
| Lab test | 126 (21) | 1 (1) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 127 (21) |
| Medical history | 101 (30) | 5 (2) | 9 (4) | 3 (3) | 0 (0) | 1 (1) | 0 (0) | 2 (2) | 121 (35) |
| Medical history, knee specific | 50 (28) | 23 (11) | 3 (2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 76 (35) |
| PROMs | 0 (0) | 12 (4) | 3 (3) | 0 (0) | 3 (2) | 0 (0) | 0 (0) | 0 (0) | 18 (7) |
| Functional | 4 (3) | 16 (8) | 3 (3) | 0 (0) | 1 (1) | 0 (0) | 0 (0) | 0 (0) | 24 (12) |
| Total | 1,211 (122) | 187 (47) | 92 (26) | 42 (14) | 22 (10) | 17 (10) | 4 (4) | 5 (4) | 1,580 (166) |
-
PROMs, patient-reported outcome measures.
Discussion
The goal of the study was to provide an evidence map of studies on prognostic factors and outcomes of rTKA. Adverse events were the most frequently reported outcomes. The most frequently used prognostic factors were reason for revision, sex, and BMI. These factors were also most frequently associated with the outcome of revision. Both the most used prognostic factors and clinical outcomes are usually part of routine registration in (electronic) patient records or as part of (national) registries.
This mapping review also identified some gaps of knowledge. Factors such as education level, living condition, and work status were not reported in the included literature at all. Also, PROMs (measuring for instance quality of life, functional status or pain) and functional tests were not often evaluated as prognostic factors. Whereas in primary TKA, prediction models have showed that a low preoperative OKS (assessing pain and function), patient-reported anxiety or depression, and higher preoperative pain ratings are associated with worse outcomes.181-183 The predictive value of these factors in revision TKA patients remains to be investigated. Moreover, these domains also matter to patients with OA, according to ICHOM.9 Together, this highlights the importance of investigating these domains in rTKA.
In the current healthcare environment, it might be useful to evaluate whether subgroups can be identified where rTKA is more cost-effective. Studies where both quality of life and costs are studied simultaneous, cost-effectiveness studies, were lacking in this evidence map. The direct costs of the surgery were only included as outcome in four studies. However, none of these four studies included the net costs; all surgical costs minus medical costs from averted adverse events and treatments. In addition, studies reporting quality of life and psychosocial impact are scarce, while improving these are important for the patient.9,10,184 During the development of the ICHOM standard set, all patients and experts of OA agreed that quality of life should be included as an outcome in the set.9 In a study of patients’ perspectives after arthroplasty, the patients prioritized pain relief, improved function, and restored quality of life as most important outcomes after hip and knee arthroplasty.184 Previous studies showed that revision hip and knee arthroplasty increased the quality-adjusted life year (QALY), although the gain in QALY was lower compared to primary arthroplasty.185,186 Also, there seems to be a considerable variation in patient outcomes across the procedures, hinting at the need to identify patients at risk for poor outcome.186
Considering preoperative psychological factors when looking at pain and functional outcomes might be of importance.187 The evidence map shows that anxiety and depression is mainly studied in association with adverse events, one study looked into the association between anxiety/depression with physical function. Although patient-reported physical functioning and pain seems to be linked with self-reported anxiety and depression in older adults and patients with knee arthroplasty, this association is lacking in this evidence map.187,188
Although over 100 different prognostic factors and outcomes were described in the included literature, they were not all completely unique. Some factors represented the same construct, but had different operationalizations. For instance, the outcomes re-revision for infection, postoperative infection, reinfection, periprosthetic joint infection, and (superficial/deep) surgical site infection all described an adverse event related to infection, in a specific location or in general. Overlap in variables was also observed in the prognostic factors; some studies reported the presence of comorbidities in general, others reported multiple specific comorbidities such as diabetes mellitus, renal failure and chronic obstructive pulmonary disease. Thus, the variety in variables found in literature is slightly lower than the evidence map suggests.
Limitations
The main limitation of the evidence map is that it only reflects the factors and outcomes that are most commonly studied, which are not necessarily the most important ones. Limitations of the individual studies might also affect the quality of the evidence map. Not all studies corrected the association between the prognostic factor and outcome for potentially confounding variables. In a minority of studies, only univariate associations were reported. The other studies did correct for confounding variables, but it is not unlikely that the models were wrongly specified and also included colliders or mediators in the multivariate models.189 The heterogeneity in model specification combined with differences between populations could partly explain the variation in associations (i.e. negative, non-significant, or positive) between a single prognostic factor and outcome that were found in the current review. As a result, the direction of the association found could deviate from the actual association.
In conclusion, the evidence map can be used to guide future research. As expected, the most frequently reported variables in rTKA studies were those that are typically registered in electronic patient files or as part of registries. While these measures are of importance in clinical settings, to further our understanding of outcomes of rTKA, it might be valuable to focus on the factors and outcomes that are studied to a lesser extent. Important gaps in literature include functional measures, psychological factors, and sociodemographic variables as prognostic factor, costs, and psychosocial impact as outcomes. Research focused on these gaps could provide a more comprehensive perspective on outcomes after rTKA and contribute to better prediction.
References
1. Chung JJ , Dolan MT , Patetta MJ , DesLaurier JT , Boroda N , Gonzalez MH . Abnormal coagulation as a risk factor for postoperative complications after primary and revision total hip and total knee arthroplasty . J Arthroplasty . 2021 ; 36 ( 9 ): 3294 – 3299 . Crossref , PubMed Google Scholar
2. Edmiston CE , Chitnis AS , Lerner J , Folly E , Holy CE , Leaper D . Impact of patient comorbidities on surgical site infection within 90 days of primary and revision joint (hip and knee) replacement . Am J Infect Control . 2019 ; 47 ( 10 ): 1225 – 1232 . Crossref , PubMed Google Scholar
3. Greidanus NV , Peterson RC , Masri BA , Garbuz DS . Quality of life outcomes in revision versus primary total knee arthroplasty . J Arthroplasty . 2011 ; 26 ( 4 ): 615 – 620 . Crossref , PubMed Google Scholar
4. Nichols CI , Vose JG . Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty . J Arthroplasty . 2016 ; 31 ( 7 ): 1400 – 1406 . Crossref , PubMed Google Scholar
5. Petersen KK , Simonsen O , Laursen MB , Nielsen TA , Rasmussen S , Arendt-Nielsen L . Chronic postoperative pain after primary and revision total knee arthroplasty . Clin J Pain . 2015 ; 31 ( 1 ): 1 – 6 . Crossref , PubMed Google Scholar
6. Gao J , Xing D , Dong S , Lin J . The primary total knee arthroplasty: a global analysis . J Orthop Surg Res . 2020 ; 15 ( 1 ): 190 . Crossref , PubMed Google Scholar
7. Dong S , Zhao Y , Li JJ , Xing D . Global research trends in revision total knee arthroplasty: a bibliometric and visualized study . Indian J Orthop . 2021 ; 55 ( 5 ): 1335 – 1347 . Crossref , PubMed Google Scholar
8. Cochrane JA , Flynn T , Wills A , Walker FR , Nilsson M , Johnson SJ . Clinical decision support tools for predicting outcomes in patients undergoing total knee arthroplasty: A Systematic Review . J Arthroplasty . 2021 ; 36 ( 5 ): 1832 – 1845 . Crossref , PubMed Google Scholar
9. Rolfson O , Wissig S , van Maasakkers L , et al. Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group . Arthritis Care Res (Hoboken) . 2016 ; 68 ( 11 ): 1631 – 1639 . Crossref , PubMed Google Scholar
10. Smith TO , Hawker GA , Hunter DJ , et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis . J Rheumatol . 2019 ; 46 ( 8 ): 981 – 989 . Crossref , PubMed Google Scholar
11. Tricco AC , Lillie E , Zarin W , et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation . Ann Intern Med . 2018 ; 169 ( 7 ): 467 – 473 . Crossref , PubMed Google Scholar
12. No authors listed . Open Science Network . https://osf.io/je26b/ ( date last accessed 21 April 2023 ). Google Scholar
13. Wickham H . ggplot2 . In : Ggplot2: Elegant Graphics for Data Analysis . Cham : Use R!: Springer International 321 Publishing , 2016 . Crossref Google Scholar
14. R Core Team . R: A Language and Environment for Statistical Computing . Vienna, Austria : R Foundation for Statistical Computing , 2021 . Google Scholar
15. Chang wc, joe; Allaire, JJ; Sievert, Carson; Schloerke, Barret; Xie, Yihui; Allen, Jeff; McPherson, Jonathan; Dipert, alan; Borges, Barbara. shiny: Web Application Framework for R . R Package Version 1.7.1 Ed2021 . Google Scholar
16. Aali-Rezaie A , Alijanipour P , Shohat N , Vahedi H , Foltz C , Parvizi J . Red cell distribution width: an unacknowledged predictor of mortality and adverse outcomes following revision arthroplasty . J Arthroplasty . 2018 ; 33 ( 11 ): 3514 – 3519 . Crossref , PubMed Google Scholar
17. Abram SGF , Sabah SA , Alvand A , Price AJ . Differences in mortality and complication rates following revision knee arthroplasty performed for urgent versus elective indications . Bone Joint J . 2021 ; 103-B ( 10 ): 1578 – 1585 . Crossref , PubMed Google Scholar
18. Aggarwal VK , Goyal N , Deirmengian G , Rangavajulla A , Parvizi J , Austin MS . Revision total knee arthroplasty in the young patient: is there trouble on the horizon? J Bone Joint Surg Am . 2014 ; 96 ( 7 ): 536 – 542 . Crossref , PubMed Google Scholar
19. Akkaya M , Vles G , Bakhtiari IG , et al. What is the rate of reinfection with different and difficult-to-treat bacteria after failed one-stage septic knee exchange? Int Orthop . 2022 ; 46 ( 4 ): 687 – 695 . Crossref , PubMed Google Scholar
20. Apinyankul R , Hwang K , Segovia NA , et al. Isolated versus full component revision in total knee arthroplasty for aseptic loosening . J Arthroplasty . 2023 ; 38 ( 2 ): 335 – 340 . Crossref , PubMed Google Scholar
21. Arndt KB , Schrøder HM , Troelsen A , Lindberg-Larsen M . Opioid and analgesic use before and after revision knee arthroplasty for the indications “pain without loosening” versus “aseptic loosening” - A Danish Nationwide Study . J Arthroplasty . 2022 ; 37 ( 8 ): 1618 – 1625 . Crossref , PubMed Google Scholar
22. Bae DK , Song SJ , Heo DB , Lee SH , Song WJ . Long-term survival rate of implants and modes of failure after revision total knee arthroplasty by a single surgeon . J Arthroplasty . 2013 ; 28 ( 7 ): 1130 – 1134 . Crossref , PubMed Google Scholar
23. Baek J-H , Lee SC , Jin H , Kim J-W , Ahn HS , Nam CH . Poor outcomes of revision total knee arthroplasty in patients with septic loosening compared to patients with aseptic loosening . J Orthop Surg Res . 2021 ; 16 ( 1 ): 624 . Crossref , PubMed Google Scholar
24. Baker P , Cowling P , Kurtz S , Jameson S , Gregg P , Deehan D . Reason for revision influences early patient outcomes after aseptic knee revision . Clin Orthop Relat Res . 2012 ; 470 ( 8 ): 2244 – 2252 . Crossref , PubMed Google Scholar
25. Barrack RL , Brumfield CS , Rorabeck CH , Cleland D , Myers L . Heterotopic ossification after revision total knee arthroplasty . Clin Orthop Relat Res . 2002 ; 404 ( 404 ): 208 – 213 . Crossref , PubMed Google Scholar
26. Bass AR , Zhang Y , Mehta B , et al. Periprosthetic joint infection is associated with an increased risk of venous thromboembolism following revision total knee replacement: an analysis of administrative discharge data . J Bone Joint Surg Am . 2021 ; 103 ( 14 ): 1312 – 1318 . Crossref , PubMed Google Scholar
27. Bedard NA , Dowdle SB , Wilkinson BG , Duchman KR , Gao Y , Callaghan JJ . What Is the impact of smoking on revision total knee arthroplasty? J Arthroplasty . 2018 ; 33 ( 7S ): S172 – S176 . Crossref , PubMed Google Scholar
28. Belmont PJ , Goodman GP , Rodriguez M , Bader JO , Waterman BR , Schoenfeld AJ . Predictors of hospital readmission following revision total knee arthroplasty . Knee Surg Sports Traumatol Arthrosc . 2016 ; 24 ( 10 ): 3329 – 3338 . Crossref , PubMed Google Scholar
29. Belt M , Hannink G , Smolders J , Spekenbrink-Spooren A , Schreurs BW , Smulders K . Reasons for revision are associated with rerevised total knee arthroplasties: an analysis of 8,978 index revisions in the Dutch Arthroplasty Register . Acta Orthop . 2021 ; 92 ( 5 ): 597 – 601 . Crossref , PubMed Google Scholar
30. Bieger R , Kappe T , Fraitzl CR , Reichel H . The aetiology of total knee arthroplasty failure influences the improvement in knee function . Arch Orthop Trauma Surg . 2013 ; 133 ( 2 ): 237 – 241 . Crossref , PubMed Google Scholar
31. Boddapati V , Fu MC , Mayman DJ , Su EP , Sculco PK , McLawhorn AS . Revision total knee arthroplasty for periprosthetic joint infection is associated with increased postoperative morbidity and mortality relative to noninfectious revisions . J Arthroplasty . 2018 ; 33 ( 2 ): 521 – 526 . Crossref , PubMed Google Scholar
32. Carter J , Springer B , Curtin BM . Early complications of revision total knee arthroplasty in morbidly obese patients . Eur J Orthop Surg Traumatol . 2019 ; 29 ( 5 ): 1101 – 1104 . Crossref , PubMed Google Scholar
33. Chalmers BP , Pallante GD , Sierra RJ , Lewallen DG , Pagnano MW , Trousdale RT . Contemporary revision total knee arthroplasty in patients younger than 50 years: 1 in 3 risk of re-revision by 10 years . J Arthroplasty . 2019 ; 34 ( 7S ): S266 – S270 . Crossref , PubMed Google Scholar
34. Chalmers BP , Syku M , Joseph AD , Mayman DJ , Haas SB , Blevins JL . High rate of re-revision in patients less than 55 years of age undergoing aseptic revision total knee arthroplasty . J Arthroplasty . 2021 ; 36 ( 7 ): 2348 – 2352 . Crossref , PubMed Google Scholar
35. Chalmers BP , Malfer CM , Mayman DJ , et al. Early survivorship of newly designed highly porous metaphyseal tibial cones in revision total knee arthroplasty . Arthroplast Today . 2021 ; 8 : 5 – 10 . Crossref , PubMed Google Scholar
36. Chen M-W , Hung J-F , Chang C-H , Lee S-H , Shih H-N , Chang Y-H . Periprosthetic knee infection reconstruction with a hinged prosthesis: Implant survival and risk factors for treatment failure . Knee . 2020 ; 27 ( 3 ): 1035 – 1042 . Crossref , PubMed Google Scholar
37. Chen J-P , Chang C-H , Lin Y-C , Lee S-H , Shih H-N , Chang Y . Two-stage exchange arthroplasty for knee periprosthetic joint infection exhibit high infection recurrence rate in patients with chronic viral hepatitis . BMC Musculoskelet Disord . 2021 ; 22 ( 1 ): 538 . Crossref , PubMed Google Scholar
38. Choi H-R , Bedair H . Mortality following revision total knee arthroplasty: a matched cohort study of septic versus aseptic revisions . J Arthroplasty . 2014 ; 29 ( 6 ): 1216 – 1218 . Crossref , PubMed Google Scholar
39. Christiner T , Sulcs M , Yates P , Prosser G . Obesity, comorbidities, and prior operations additively increase failure in 2-stage revision total knee arthroplasty for prosthetic joint infection . J Arthroplasty . 2022 ; 37 ( 2 ): 353 – 358 . Crossref , PubMed Google Scholar
40. Churchill JL , Samuel LT , Karnuta JM , Acuña AJ , Kamath AF . The association of international normalized ratio with postoperative complications in revision total knee arthroplasty . J Knee Surg . 2021 ; 34 ( 7 ): 721 – 729 . Crossref , PubMed Google Scholar
41. Citak M , Friedenstab J , Abdelaziz H , et al. Risk factors for failure after 1-stage exchange total knee arthroplasty in the management of periprosthetic joint infection . J Bone Joint Surg Am . 2019 ; 101 ( 12 ): 1061 – 1069 . Crossref , PubMed Google Scholar
42. Cochrane NH , Kim B , Seyler TM , Bolognesi MP , Wellman SS , Ryan SP . Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation . Bone Joint J . 2022 ; 104-B ( 12 ): 1323 – 1328 . Crossref , PubMed Google Scholar
43. Cochrane NH , Wellman SS , Lachiewicz PF . Early infection after aseptic revision knee arthroplasty: prevalence and predisposing risk factors . J Arthroplasty . 2022 ; 37 ( 6S ): S281 – S285 . Crossref , PubMed Google Scholar
44. Cohen JS , Gu A , Wei C , et al. Preoperative estimated glomerular filtration rate is a marker for postoperative complications following revision total knee arthroplasty . J Arthroplasty . 2019 ; 34 ( 4 ): 750 – 754 . Crossref , PubMed Google Scholar
45. Courtney PM , Boniello AJ , Della Valle CJ , Lee G-C . Risk adjustment is necessary in value-based outcomes models for infected TKA . Clin Orthop Relat Res . 2018 ; 476 ( 10 ): 1940 – 1948 . Crossref , PubMed Google Scholar
46. Dahlgren N , Lehtonen E , Anderson M , et al. Readmission following revision total knee arthroplasty: an institutional cohort . Cureus . 2018 ; 10 ( 11 ): e3640 . Crossref , PubMed Google Scholar
47. Dai W-L , Lin Z-M , Shi Z-J , Wang J . Outcomes following Revision Total Knee Arthroplasty Septic versus Aseptic Failure: A National Propensity-Score-Matched Comparison . J Knee Surg . 2021 ; 34 ( 11 ): 1227 – 1236 . Crossref , PubMed Google Scholar
48. de Carvalho RT , Santos DB , Chammas V , Arrebola LS , Colombo ML , Scalizi C . Influence of body mass index in revision total knee arthroplasty . Acta Ortop Bras . 2015 ; 23 ( 6 ): 290 – 293 . Crossref , PubMed Google Scholar
49. Deehan DJ , Murray JD , Birdsall PD , Pinder IM . Quality of life after knee revision arthroplasty . Acta Orthop . 2006 ; 77 ( 5 ): 761 – 766 . Crossref , PubMed Google Scholar
50. Deere K , Whitehouse MR , Kunutsor SK , et al. How long do revised and multiply revised knee replacements last? an analysis of the national joint registry . Lancet Rheumatol . 2021 ; 3 ( 6 ): e438 – e446 . Crossref , PubMed Google Scholar
51. DeMik DE , Carender CN , Glass NA , Brown TS , Callaghan JJ , Bedard NA . Who Is still receiving blood transfusions after primary and revision total joint arthroplasty? J Arthroplasty . 2022 ; 37 ( 6S ): S63 – S69 . Crossref , PubMed Google Scholar
52. Dieterich JD , Fields AC , Moucha CS . Short term outcomes of revision total knee arthroplasty . J Arthroplasty . 2014 ; 29 ( 11 ): 2163 – 2166 . Crossref , PubMed Google Scholar
53. Dowdle SB , Bedard NA , Owens JM , Gao Y , Callaghan JJ . Identifying risk factors for the development of stiffness after revision total knee arthroplasty . J Arthroplasty . 2018 ; 33 ( 4 ): 1186 – 1188 . Crossref , PubMed Google Scholar
54. Drain NP , Bertolini DM , Anthony AW , et al. high mortality after total knee arthroplasty periprosthetic joint infection is related to preoperative morbidity and the disease process but not treatment . J Arthroplasty . 2022 ; 37 ( 7 ): 1383 – 1389 . Crossref , PubMed Google Scholar
55. Faschingbauer M , Bieger R , Kappe T , Weiner C , Freitag T , Reichel H . Difficult to treat: are there organism-dependent differences and overall risk factors in success rates for two-stage knee revision? Arch Orthop Trauma Surg . 2020 ; 140 ( 11 ): 1595 – 1602 . Crossref , PubMed Google Scholar
56. Fassihi SC , Gu A , Perim DA , et al. Chronic preoperative corticosteroid use is not associated with surgical site infection following revision total knee arthroplasty . J Orthop . 2020 ; 20 : 173 – 176 . Crossref , PubMed Google Scholar
57. Fleischman AN , Azboy I , Fuery M , Restrepo C , Shao H , Parvizi J . Effect of stem size and fixation method on mechanical failure after revision total knee arthroplasty . J Arthroplasty . 2017 ; 32 ( 9S ): S202 – S208 . Crossref , PubMed Google Scholar
58. Fury MS , Klemt C , Barghi A , Tirumala V , van den Kieboom J , Kwon Y-M . Preoperative serum c-reactive protein/albumin ratio is a predictor of complications after single-stage revision for the treatment of periprosthetic joint infection . J Am Acad Orthop Surg . 2021 ; 29 ( 20 ): e1013 – e1024 . Crossref , PubMed Google Scholar
59. Gao Z , Du Y , Piao S , Sun J , Li X , Zhou Y . Comparison between the Staphylococci aureus and coagulase-negative staphylococci infected total joint arthroplasty treated by two-stage revision: A retrospective study with two year minimum follow-up . J Orthop Sci . 2019 ; 24 ( 1 ): 109 – 115 . Crossref , PubMed Google Scholar
60. Geary MB , Macknet DM , Ransone MP , Odum SD , Springer BD . Why do revision total knee arthroplasties fail? a single-center review of 1632 revision total knees comparing historic and modern cohorts . J Arthroplasty . 2020 ; 35 ( 10 ): 2938 – 2943 . Crossref , PubMed Google Scholar
61. Ghanem E , Restrepo C , Joshi A , Hozack W , Sharkey P , Parvizi J . Periprosthetic infection does not preclude good outcome for revision arthroplasty . Clin Orthop Relat Res . 2007 ; 461 : 54 – 59 . Crossref Google Scholar
62. Ghomrawi HMK , Kane RL , Eberly LE , Bershadsky B , Saleh KJ , North American Knee Arthroplasty Revision (NAKAR) Study Group . Patterns of functional improvement after revision knee arthroplasty . J Bone Joint Surg Am . 2009 ; 91 ( 12 ): 2838 – 2845 . Crossref , PubMed Google Scholar
63. Goh GS , Khow YZ , Tay DK , Lo N-N , Yeo S-J , Liow MHL . Preoperative Mental Health Influences Patient-Reported Outcome Measures and Satisfaction After Revision Total Knee Arthroplasty . J Arthroplasty . 2021 ; 36 ( 8 ): 2878 – 2886 . Crossref , PubMed Google Scholar
64. Grayson CW , Warth LC , Ziemba-Davis MM , Michael Meneghini R . Functional Improvement and Expectations Are Diminished in Total Knee Arthroplasty Patients Revised for Flexion Instability Compared to Aseptic Loosening and Infection . J Arthroplasty . 2016 ; 31 ( 10 ): 2241 – 2246 . Crossref , PubMed Google Scholar
65. Gu A , Wei C , Maybee CM , Sobrio SA , Abdel MP , Sculco PK . The Impact of Chronic Obstructive Pulmonary Disease on Postoperative Outcomes in Patients Undergoing Revision Total Knee Arthroplasty . J Arthroplasty . 2018 ; 33 ( 9 ): 2956 – 2960 . Crossref , PubMed Google Scholar
66. Goh GS , Fillingham YA , Ong CB , Krueger CA , Courtney PM , Hozack WJ . Redefining Indications for Modern Cementless Total Knee Arthroplasty: Clinical Outcomes and Survivorship in Patients >75 Years Old . J Arthroplasty . 2022 ; 37 ( 3 ): 476 – 481 . Crossref , PubMed Google Scholar
67. Gu A , Chen AZ , Selemon NA , et al. Preoperative anemia independently predicts significantly increased odds of short-term complications following aseptic revision hip and knee arthroplasty . J Arthroplasty . 2021 ; 36 ( 5 ): 1719 – 1728 . Crossref , PubMed Google Scholar
68. Gu A , Maybee CM , Wei C , Probasco WV , Ast MP , Sculco PK . Preoperative blood transfusion associated with increased length of stay and increased postoperative complications after revision total knee arthroplasty . J Orthop . 2019 ; 16 ( 3 ): 265 – 268 . Crossref , PubMed Google Scholar
69. Gu A , Wei C , Bernstein SA , et al. The impact of gender on postoperative complications after revision total knee arthroplasty . J Knee Surg . 2020 ; 33 ( 4 ): 387 – 393 . Crossref , PubMed Google Scholar
70. Hagerty MP , Walker-Santiago R , Tegethoff JD , Stronach BM , Keeney JA . Tobacco use is associated with more severe adverse outcomes than morbid obesity after aseptic revision TKA . J Knee Surg . 2023 ; 36 ( 2 ): 201 – 207 . Crossref , PubMed Google Scholar
71. Halder AM , Gehrke T , Günster C , et al. Low Hospital Volume Increases Re-Revision Rate Following Aseptic Revision Total Knee Arthroplasty: An Analysis of 23,644 Cases . J Arthroplasty . 2020 ; 35 ( 4 ): 1054 – 1059 . Crossref , PubMed Google Scholar
72. Hamaway S , Hadid B , Vakharia RM , et al. The association of iron deficiency anemia and perioperative complications following revision total knee arthroplasty . Arthroplasty . 2022 ; 4 ( 1 ): 34 . Crossref , PubMed Google Scholar
73. Hannon CP , Kruckeberg BM , Pagnano MW , Berry DJ , Hanssen AD , Abdel MP . Revision total knee arthroplasty for flexion instability: a concise follow-up of a previous report . Bone Joint J . 2022 ; 104-B ( 10 ): 1126 – 1131 . Crossref , PubMed Google Scholar
74. Hardcastle JM , So DH , Lee G-C . The Fate of revision total knee arthroplasty with preoperative abnormalities in either sedimentation rate or c-reactive protein . J Arthroplasty . 2016 ; 31 ( 12 ): 2831 – 2834 . Crossref , PubMed Google Scholar
75. Hardeman F , Londers J , Favril A , Witvrouw E , Bellemans J , Victor J . Predisposing factors which are relevant for the clinical outcome after revision total knee arthroplasty . Knee Surg Sports Traumatol Arthrosc . 2012 ; 20 ( 6 ): 1049 – 1056 . Crossref PubMed Google Scholar
76. Heesterbeek PJC , Goosen JHM , Schimmel JJP , Defoort KC , van Hellemondt GG , Wymenga AB . Moderate clinical improvement after revision arthroplasty of the severely stiff knee . Knee Surg Sports Traumatol Arthrosc . 2016 ; 24 ( 10 ): 3235 – 3241 . Crossref PubMed Google Scholar
77. Hernigou P , Dubory A , Potage D , Roubineau F , Flouzat-Lachaniette CH . Outcome of knee revisions for osteoarthritis and inflammatory arthritis with postero-stabilized arthroplasties: a mean ten-year follow-up with 90 knee revisions . Int Orthop . 2017 ; 41 ( 4 ): 757 – 763 . Crossref , PubMed Google Scholar
78. Hoell S , Sieweke A , Gosheger G , et al. Eradication rates, risk factors, and implant selection in two-stage revision knee arthroplasty: a mid-term follow-up study . J Orthop Surg Res . 2016 ; 11 ( 1 ): 93 . Crossref , PubMed Google Scholar
79. Ingall E , Klemt C , Melnic CM , Cohen-Levy WB , Tirumala V , Kwon YM . Impact of preoperative opioid use on patient-reported outcomes after revision total knee arthroplasty: a propensity matched analysis . J Knee Surg . 2023 ; 36 ( 2 ): 115 – 120 . Crossref , PubMed Google Scholar
80. Jannelli E , Ivone A , Rossi S , et al. Clinical outcomes of revision total knee arthroplasty among different etiologies and treated with a condylar constrained knee implant supported with cones . Applied Sciences . 2022 ; 12 ( 19 ): 10117 . Crossref Google Scholar
81. Jeschke E , Citak M , Halder AM , et al. Blood transfusion and venous thromboembolism trends and risk factors in primary and aseptic revision total hip and knee arthroplasties: A nationwide investigation of 736,061 cases . Orthop Traumatol Surg Res . 2022 ; 108 ( 1 ): 102987 . Crossref , PubMed Google Scholar
82. Kamath AF , Nelson CL , Elkassabany N , Guo Z , Liu J . Low Albumin Is a Risk Factor for Complications after Revision Total Knee Arthroplasty . J Knee Surg . 2017 ; 30 ( 3 ): 269 – 275 . Crossref , PubMed Google Scholar
83. Kasmire KE , Rasouli MR , Mortazavi SMJ , Sharkey PF , Parvizi J . Predictors of functional outcome after revision total knee arthroplasty following aseptic failure . Knee . 2014 ; 21 ( 1 ): 264 – 267 . Crossref , PubMed Google Scholar
84. Keswani A , Lovy AJ , Robinson J , Levy R , Chen D , Moucha CS . Risk Factors Predict Increased Length of Stay and Readmission Rates in Revision Joint Arthroplasty . J Arthroplasty . 2016 ; 31 ( 3 ): 603 – 608 . Crossref , PubMed Google Scholar
85. Kienzle A , Walter S , von Roth P , Fuchs M , Winkler T , Müller M . High Rates of Aseptic Loosening After Revision Total Knee Arthroplasty for Periprosthetic Joint Infection . JB JS Open Access . 2020 ; 5 ( 3 ): e20.00026 . Crossref , PubMed Google Scholar
86. Kildow BJ , Springer BD , Brown TS , Lyden ER , Fehring TK , Garvin KL . Long term results of two-stage revision for chronic periprosthetic knee infection: a multicenter study . J Arthroplasty . 2022 ; 37 ( 6S ): S327 – S332 . Crossref , PubMed Google Scholar
87. Kim GK , Mortazavi SMJ , Purtill JJ , Sharkey PF , Hozack WJ , Parvizi J . Stiffness after revision total knee arthroplasty . J Arthroplasty . 2010 ; 25 ( 6 ): 844 – 850 . Crossref , PubMed Google Scholar
88. Kim MS , Koh IJ , Sohn S , Kang BM , Kwak DH , In Y . Central sensitization is a risk factor for persistent postoperative pain and dissatisfaction in patients undergoing revision total knee arthroplasty . J Arthroplasty . 2019 ; 34 ( 8 ): 1740 – 1748 . Crossref , PubMed Google Scholar
89. Kingsbury SR , Smith LK , Shuweihdi F , et al. A comparative study of patients presenting for planned and unplanned revision hip or knee arthroplasty . Bone Joint J . 2022 ; 104-B ( 1 ): 59 – 67 . Crossref , PubMed Google Scholar
90. Kirschbaum S , Erhart S , Perka C , Hube R , Thiele K . Failure Analysis in Multiple TKA Revisions-Periprosthetic Infections Remain Surgeons’ Nemesis . J Clin Med . 2022 ; 11 ( 2 ): 376 . Crossref , PubMed Google Scholar
91. Klasan A , Magill P , Frampton C , Zhu M , Young SW . Factors predicting repeat revision and outcome after aseptic revision total knee arthroplasty: results from the New Zealand Joint Registry . Knee Surg Sports Traumatol Arthrosc . 2021 ; 29 ( 2 ): 579 – 585 . Crossref , PubMed Google Scholar
92. Klasan A , Gerber F , Schermuksnies A , Putnis SE , Neri T , Heyse TJ . Blood loss after revision knee arthroplasty is 1.38- to 2.17-fold higher than after primary knee arthroplasty: A retrospective analysis of 898 cases . Orthop Traumatol Surg Res . 2021 ; 107 ( 3 ): 102856 . Crossref , PubMed Google Scholar
93. Klemt C , Uzosike AC , Harvey MJ , Laurencin S , Habibi Y , Kwon Y-M . Neural network models accurately predict discharge disposition after revision total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc . 2022 ; 30 ( 8 ): 2591 – 2599 . Crossref , PubMed Google Scholar
94. Klemt C , Tirumala V , Barghi A , Cohen-Levy WB , Robinson MG , Kwon Y-M . Artificial intelligence algorithms accurately predict prolonged length of stay following revision total knee arthroplasty . Knee Surg Sports Traumatol Arthrosc . 2022 ; 30 ( 8 ): 2556 – 2564 . Crossref , PubMed Google Scholar
95. Kubista B , Hartzler RU , Wood CM , Osmon DR , Hanssen AD , Lewallen DG . Reinfection after two-stage revision for periprosthetic infection of total knee arthroplasty . Int Orthop . 2012 ; 36 ( 1 ): 65 – 71 . Crossref , PubMed Google Scholar
96. Kurd MF , Ghanem E , Steinbrecher J , Parvizi J . Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome? Clin Orthop Relat Res . 2010 ; 468 ( 8 ): 2060 – 2066 . Crossref , PubMed Google Scholar
97. Labaran LA , Sequeira S , Bolarinwa SA , et al. Outcomes following revision joint arthroplasty among hemodialysis-dependent patients . J Arthroplasty . 2020 ; 35 ( 6S ): S273 – S277 . Crossref , PubMed Google Scholar
98. Labaran LA , Amin R , Bolarinwa SA , et al. Revision Joint Arthroplasty and Renal Transplant: A Matched Control Cohort Study . J Arthroplasty . 2020 ; 35 ( 1 ): 224 – 228 . Crossref , PubMed Google Scholar
99. Larson DJ , Rosenberg JH , Lawlor MA , et al. Pain associated with cemented and uncemented long-stemmed tibial components in revision total knee arthroplasty . Bone Joint J . 2021 ; 103-B ( 6 Supple A ): 165 – 170 . Crossref , PubMed Google Scholar
100. Laudermilch DJ , Fedorka CJ , Heyl A , Rao N , McGough RL . Outcomes of revision total knee arthroplasty after methicillin-resistant Staphylococcus aureus infection . Clin Orthop Relat Res . 2010 ; 468 ( 8 ): 2067 – 2073 . Crossref , PubMed Google Scholar
101. Lee D-H , Lee S-H , Song E-K , Seon J-K , Lim H-A , Yang H-Y . Causes and Clinical Outcomes of Revision Total Knee Arthroplasty . Knee Surg Relat Res . 2017 ; 29 ( 2 ): 104 – 109 . Crossref , PubMed Google Scholar
102. Lee D , Lee R , Gowda NB , et al. Impact of diabetes mellitus on surgical complications in patients undergoing revision total knee arthroplasty: Insulin dependence makes a difference . J Clin Orthop Trauma . 2020 ; 11 ( 1 ): 140 – 146 . Crossref , PubMed Google Scholar
103. Lee D , Lee R , Strum D , Heyer JH , Swansen T , Pandarinath R . The impact of chronic kidney disease on postoperative complications in patients undergoing revision total knee arthroplasty: A propensity matched analysis . J Clin Orthop Trauma . 2020 ; 11 ( 1 ): 147 – 153 . Crossref , PubMed Google Scholar
104. Leta TH , Lygre SHL , Skredderstuen A , Hallan G , Furnes O . Failure of aseptic revision total knee arthroplasties . Acta Orthop . 2015 ; 86 ( 1 ): 48 – 57 . Crossref , PubMed Google Scholar
105. Liang H , Bae JK , Park CH , Kim KI , Bae DK , Song SJ . Comparison of mode of failure between primary and revision total knee arthroplasties . Orthop Traumatol Surg Res . 2018 ; 104 ( 2 ): 171 – 176 . Crossref , PubMed Google Scholar
106. Lindberg-Larsen M , Petersen PB , Corap Y , et al. Fast-track revision knee arthroplasty . Knee . 2022 ; 34 : 24 – 33 . Crossref , PubMed Google Scholar
107. Liodakis E , Bergeron SG , Zukor DJ , Huk OL , Epure LM , Antoniou J . Perioperative complications and length of stay after revision total hip and knee arthroplasties: an analysis of the nsqip database . J Arthroplasty . 2015 ; 30 ( 11 ): 1868 – 1871 . Crossref , PubMed Google Scholar
108. López-de-Andrés A , Hernández-Barrera V , Martínez-Huedo MA , Villanueva-Martinez M , Jiménez-Trujillo I , Jiménez-García R . Type 2 diabetes and in-hospital complications after revision of total hip and knee arthroplasty . PLoS One . 2017 ; 12 ( 8 ): e0183796 . Crossref , PubMed Google Scholar
109. Lu M , Sing DC , Kuo AC , Hansen EN . Preoperative Anemia Independently Predicts 30-Day Complications After Aseptic and Septic Revision Total Joint Arthroplasty . J Arthroplasty . 2017 ; 32 ( 9S ): S197 – S201 . Crossref , PubMed Google Scholar
110. Luque R , Rizo B , Urda A , et al. Predictive factors for failure after total knee replacement revision . Int Orthop . 2014 ; 38 ( 2 ): 429 – 435 . Crossref , PubMed Google Scholar
111. Ma C-Y , Lu Y-D , Bell KL , et al. Predictors of treatment failure after 2-stage reimplantation for infected total knee arthroplasty: A 2- to 10-Year Follow-Up . J Arthroplasty . 2018 ; 33 ( 7 ): 2234 – 2239 . Crossref , PubMed Google Scholar
112. Mahomed NN , Barrett J , Katz JN , Baron JA , Wright J , Losina E . Epidemiology of total knee replacement in the United States Medicare population . J Bone Joint Surg Am . 2005 ; 87 ( 6 ): 1222 – 1228 . Crossref , PubMed Google Scholar
113. Malviya A , Brewster NT , Bettinson K , Holland JP , Weir DJ , Deehan DJ . Functional outcome following aseptic single-stage revision knee arthroplasty . Knee Surg Sports Traumatol Arthrosc . 2012 ; 20 ( 10 ): 1994 – 2001 . Crossref , PubMed Google Scholar
114. Malviya A , Bettinson K , Kurtz SM , Deehan DJ . When do patient-reported assessments peak after revision knee arthroplasty? Clin Orthop Relat Res . 2012 ; 470 ( 6 ): 1728 – 1734 . Crossref , PubMed Google Scholar
115. Massin P , Delory T , Lhotellier L , et al. Infection recurrence factors in one- and two-stage total knee prosthesis exchanges . Knee Surg Sports Traumatol Arthrosc . 2016 ; 24 ( 10 ): 3131 – 3139 . Crossref , PubMed Google Scholar
116. Matar HE , Bloch BV , Snape SE , James PJ . Septic revision total knee arthroplasty is associated with significantly higher mortality than aseptic revisions: long-term single-center study (1254 patients) . J Arthroplasty . 2021 ; 36 ( 6 ): 2131 – 2136 . Crossref , PubMed Google Scholar
117. Matar HE , Bloch BV , Snape SE , James PJ . Outcomes of single- and two-stage revision total knee arthroplasty for chronic periprosthetic joint infection: long-term outcomes of changing clinical practice in a specialist centre . Bone Joint J . 2021 ; 103-B ( 8 ): 1373 – 1379 . Crossref , PubMed Google Scholar
118. Meyer JA , Zhu M , Cavadino A , Coleman B , Munro JT , Young SW . Infection and periprosthetic fracture are the leading causes of failure after aseptic revision total knee arthroplasty . Arch Orthop Trauma Surg . 2021 ; 141 ( 8 ): 1373 – 1383 . Crossref , PubMed Google Scholar
119. Mortazavi SMJ , Molligan J , Austin MS , Purtill JJ , Hozack WJ , Parvizi J . Failure following revision total knee arthroplasty: infection is the major cause . Int Orthop . 2011 ; 35 ( 8 ): 1157 – 1164 . Crossref , PubMed Google Scholar
120. Mulhall KJ , Ghomrawi HM , Mihalko W , Cui Q , Saleh KJ . Adverse effects of increased body mass index and weight on survivorship of total knee arthroplasty and subsequent outcomes of revision TKA . J Knee Surg . 2007 ; 20 ( 3 ): 199 – 204 . Crossref , PubMed Google Scholar
121. Nikolaus OB , McLendon PB , Hanssen AD , Mabry TM , Berbari EF , Sierra RJ . Factors Associated With 20-Year Cumulative Risk of Infection After Aseptic Index Revision Total Knee Arthroplasty . J Arthroplasty . 2016 ; 31 ( 4 ): 872 – 877 . Crossref , PubMed Google Scholar
122. Novicoff WM , Rion D , Mihalko WM , Saleh KJ . Does concomitant low back pain affect revision total knee arthroplasty outcomes? Clin Orthop Relat Res . 2009 ; 467 ( 10 ): 2623 – 2629 . Crossref , PubMed Google Scholar
123. Oganesyan R , Klemt C , Esposito J , Tirumala V , Xiong L , Kwon Y-M . Knee arthroscopy prior to revision tka is associated with increased re-revision for stiffness . J Knee Surg . 2022 ; 35 ( 11 ): 1223 – 1228 . Crossref , PubMed Google Scholar
124. Patil N , Lee K , Huddleston JI , Harris AHS , Goodman SB . Aseptic versus septic revision total knee arthroplasty: patient satisfaction, outcome and quality of life improvement . Knee . 2010 ; 17 ( 3 ): 200 – 203 . Crossref , PubMed Google Scholar
125. Piuzzi NS , and the Cleveland Clinic OME Arthroplasty Group . Patient-Reported Outcome Measures (Pain, Function, and Quality of Life) After Aseptic Revision Total Knee Arthroplasty . J Bone Joint Surg Am . 2020 ; 102 ( 20 ): e114 . Crossref , PubMed Google Scholar
126. Pun SY , Ries MD . Effect of gender and preoperative diagnosis on results of revision total knee arthroplasty . Clin Orthop Relat Res . 2008 ; 466 ( 11 ): 2701 – 2705 . Crossref , PubMed Google Scholar
127. Quinn J , Jones P , Randle R . Clinical outcomes following revision total knee arthroplasty: minimum 2-year follow-up . Clin Orthop Surg . 2022 ; 14 ( 1 ): 69 – 75 . Crossref , PubMed Google Scholar
128. Rajgopal A , Panda I , Rao A , Dahiya V , Gupta H . Does Prior Failed Debridement Compromise the Outcome of Subsequent Two-Stage Revision Done for Periprosthetic Joint Infection Following Total Knee Arthroplasty? J Arthroplasty . 2018 ; 33 ( 8 ): 2588 – 2594 . Crossref , PubMed Google Scholar
129. Rajgopal A , Vasdev A , Gupta H , Dahiya V . Revision total knee arthroplasty for septic versus aseptic failure . J Orthop Surg (Hong Kong) . 2013 ; 21 ( 3 ): 285 – 289 . Crossref , PubMed Google Scholar
130. Reeves RA , Schairer WW , Jevsevar DS . Costs and Risk Factors for Hospital Readmission After Periprosthetic Knee Fractures in the United States . J Arthroplasty . 2018 ; 33 ( 2 ): 324 – 330 . Crossref , PubMed Google Scholar
131. Ritter MA , Berend ME , Harty LD , Davis KE , Meding JB , Keating EM . Predicting range of motion after revision total knee arthroplasty: clustering and log-linear regression analyses . J Arthroplasty . 2004 ; 19 ( 3 ): 338 – 343 . Crossref , PubMed Google Scholar
132. Ro DH , Kim J-K , Kim S , Han H-S , Lee MC . Periprosthetic Joint Infection Does Not Preclude Good Outcomes after A Revision Total Knee Arthroplasty: A 7-Year Follow-Up Study of 144 Retrospective Cases . Biomed Res Int . 2018 ; 2018 : 2582140 . Crossref , PubMed Google Scholar
133. Ross BJ , Ross AJ , Cole MW , Guild GN , Lee OC , Sherman WF . The Impact of Hepatitis C on Complication Rates After Revision Total Knee Arthroplasty: A Matched Cohort Study . Arthroplast Today . 2022 ; 18 ( 6 Suppl 1 ): 212 – 218 . Crossref , PubMed Google Scholar
134. Rossmann M , Minde T , Citak M , et al. High rate of reinfection with new bacteria following one-stage exchange for enterococcal periprosthetic infection of the knee: a single-center study . J Arthroplasty . 2021 ; 36 ( 2 ): 711 – 716 . Crossref , PubMed Google Scholar
135. Roth A , Khlopas A , George J , et al. The Effect of Body Mass Index on 30-day Complications After Revision Total Hip and Knee Arthroplasty . J Arthroplasty . 2019 ; 34 ( 7S ): S242 – S248 . Crossref , PubMed Google Scholar
136. Russo A , Cavagnaro L , Chiarlone F , Alessio-Mazzola M , Felli L , Burastero G . Predictors of failure of two-stage revision in periprosthetic knee infection: a retrospective cohort study with a minimum two-year follow-up . Arch Orthop Trauma Surg . 2022 ; 142 ( 3 ): 481 – 490 . Crossref , PubMed Google Scholar
137. Sabah SA , Alvand A , Knight R , Beard DJ , Price AJ . Patient-Reported Function and Quality of Life After Revision Total Knee Arthroplasty: An Analysis of 10,727 Patients from the NHS PROMs Program . J Arthroplasty . 2021 ; 36 ( 8 ): 2887 – 2895 . Crossref , PubMed Google Scholar
138. Sabry FY , Buller L , Ahmed S , Klika AK , Barsoum WK . Preoperative prediction of failure following two-stage revision for knee prosthetic joint infections . J Arthroplasty . 2014 ; 29 ( 1 ): 115 – 121 . Crossref , PubMed Google Scholar
139. Sakellariou VI , Poultsides LA , Vasilakakos T , Sculco P , Ma Y , Sculco TP . Risk factors for recurrence of periprosthetic knee infection . J Arthroplasty . 2015 ; 30 ( 9 ): 1618 – 1622 . Crossref , PubMed Google Scholar
140. Samuel LT , Sultan AA , Zhou G , et al. In-hospital mortality after septic revision tka: analysis of the new york and florida state inpatient databases . J Knee Surg . 2022 ; 35 ( 4 ): 416 – 423 . Crossref , PubMed Google Scholar
141. Schairer WW , Vail TP , Bozic KJ . What are the rates and causes of hospital readmission after total knee arthroplasty? Clin Orthop Relat Res . 2014 ; 472 ( 1 ): 181 – 187 . Crossref , PubMed Google Scholar
142. Schwarze J , Dieckmann R , Gosheger G , Bensmann M , Moellenbeck B , Theil C . Unsuspected positive cultures in planned aseptic revision knee or hip arthroplasty-risk factors and impact on survivorship . J Arthroplasty . 2022 ; 37 ( 6 ): 1165 – 1172 . Crossref , PubMed Google Scholar
143. Shen TS , Gu A , Bovonratwet P , Ondeck NT , Sculco PK , Su EP . Patients who undergo early aseptic revision tka within 90 days of surgery have a high risk of re-revision and infection at 2 years: a large-database study . Clin Orthop Relat Res . 2022 ; 480 ( 3 ): 495 – 503 . Crossref , PubMed Google Scholar
144. Sheng PY , Konttinen L , Lehto M , Ogino D , Jamsen E , Nevalainen J . A review of the finnish arthroplasty registry . J Bone Joint Surg Am . 2002 ; 88-A ( 7 ): 1425 – 1430 . Crossref , PubMed Google Scholar
145. Sinclair ST , Orr MN , Rothfusz CA , Klika AK , McLaughlin JP , Piuzzi NS . Understanding the 30-day mortality burden after revision total knee arthroplasty . Arthroplast Today . 2021 ; 11 : 205 – 211 . Crossref , PubMed Google Scholar
146. Singh JA , Lewallen DG . Depression in primary TKA and higher medical comorbidities in revision TKA are associated with suboptimal subjective improvement in knee function . BMC Musculoskelet Disord . 2014 ; 15 : 127 . Crossref , PubMed Google Scholar
147. Singh JA , Jensen M , Lewallen D . Predictors of periprosthetic fracture after total knee replacement: an analysis of 21,723 cases . Acta Orthop . 2013 ; 84 ( 2 ): 170 – 177 . Crossref , PubMed Google Scholar
148. Singh JA , Gabriel SE , Lewallen DG . Higher body mass index is not associated with worse pain outcomes after primary or revision total knee arthroplasty . J Arthroplasty . 2011 ; 26 ( 3 ): 366 – 374 . Crossref , PubMed Google Scholar
149. Singh JA , Lewallen DG . Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee arthroplasty . BMC Med . 2013 ; 11 : 144 . Crossref , PubMed Google Scholar
150. Singh JA , Lewallen DG . Medical and psychological comorbidity predicts poor pain outcomes after total knee arthroplasty . Rheumatology (Oxford) . 2013 ; 52 ( 5 ): 916 – 923 . Crossref , PubMed Google Scholar
151. Singh JA , O’Byrne MM , Harmsen WS , Lewallen DG . Predictors of moderate-severe functional limitation 2 and 5 years after revision total knee arthroplasty . J Arthroplasty . 2010 ; 25 ( 7 ): 1091 – 1095 . Crossref , PubMed Google Scholar
152. Singh JA , Lewallen DG . Predictors of pain medication use for arthroplasty pain after revision total knee arthroplasty . Rheumatology (Oxford) . 2014 ; 53 ( 10 ): 1752 – 1758 . Crossref , PubMed Google Scholar
153. Singh JA , Lewallen DG . Underlying diagnosis predicts patient-reported outcomes after revision total knee arthroplasty . Rheumatology (Oxford) . 2014 ; 53 ( 2 ): 361 – 366 . Crossref , PubMed Google Scholar
154. Siqueira MBP , Jacob P , McLaughlin J , et al. The Varus-Valgus Constrained Knee Implant: Survivorship and Outcomes . J Knee Surg . 2017 ; 30 ( 5 ): 484 – 492 . Crossref , PubMed Google Scholar
155. Sisko ZW , Vasarhelyi EM , Somerville LE , Naudie DD , MacDonald SJ , McCalden RW . Morbid Obesity in Revision Total Knee Arthroplasty: A Significant Risk Factor for Re-Operation . J Arthroplasty . 2019 ; 34 ( 5 ): 932 – 938 . Crossref , PubMed Google Scholar
156. Sloan M , Sheth N , Lee G-C . Is Obesity Associated With Increased Risk of Deep Vein Thrombosis or Pulmonary Embolism After Hip and Knee Arthroplasty? A Large Database Study . Clin Orthop Relat Res . 2019 ; 477 ( 3 ): 523 – 532 . Crossref , PubMed Google Scholar
157. Sodhi N , Anis HK , Vakharia RM , et al. What are risk factors for infection after primary or revision total joint arthroplasty in patients older than 80 years? Clin Orthop Relat Res . 2020 ; 478 ( 8 ): 1741 – 1751 . Crossref , PubMed Google Scholar
158. Staats K , Kolbitsch P , Sigmund IK , Hobusch GM , Holinka J , Windhager R . Outcome of Total Hip and Total Knee Revision Arthroplasty With Minor Infection Criteria: A Retrospective Matched-Pair Analysis . J Arthroplasty . 2017 ; 32 ( 4 ): 1266 – 1271 . Crossref , PubMed Google Scholar
159. Sternheim A , Lochab J , Drexler M , et al. The benefit of revision knee arthroplasty for component malrotation after primary total knee replacement . Int Orthop . 2012 ; 36 ( 12 ): 2473 – 2478 . Crossref , PubMed Google Scholar
160. Suarez J , Griffin W , Springer B , Fehring T , Mason JB , Odum S . Why do revision knee arthroplasties fail? J Arthroplasty . 2008 ; 23 ( 6 Suppl 1 ): 99 – 103 . Crossref , PubMed Google Scholar
161. Theil C , Schwarze J , Gosheger G , et al. Good to excellent long-term survival of a single-design condylar constrained knee arthroplasty for primary and revision surgery . Knee Surg Sports Traumatol Arthrosc . 2022 ; 30 ( 9 ): 3184 – 3190 . Crossref , PubMed Google Scholar
162. Traven SA , Reeves RA , Slone HS , Walton ZJ . Frailty predicts medical complications, length of stay, readmission, and mortality in revision hip and knee arthroplasty . J Arthroplasty . 2019 ; 34 ( 7 ): 1412 – 1416 . Crossref , PubMed Google Scholar
163. Turnbull GS , Scott CEH , MacDonald DJ , Breusch SJ . Gender and preoperative function predict physical activity levels after revision total knee arthroplasty . J Arthroplasty . 2019 ; 34 ( 5 ): 939 – 946 . Crossref , PubMed Google Scholar
164. Upfill-Brown A , Wu SY , Hart C , et al. Revision total knee arthroplasty outcomes in solid organ transplant Patients, a matched cohort study of aseptic and infected revisions . Knee . 2022 ; 34 : 231 – 237 . Crossref , PubMed Google Scholar
165. van den Kieboom J , Tirumala V , Xiong L , Klemt C , Kwon Y-M . Periprosthetic joint infection is the main reason for failure in patients following periprosthetic fracture treated with revision arthroplasty . Arch Orthop Trauma Surg . 2022 ; 142 ( 12 ): 3565 – 3574 . Crossref , PubMed Google Scholar
166. van Kempen R , Schimmel JJP , van Hellemondt GG , Vandenneucker H , Wymenga AB . Reason for revision TKA predicts clinical outcome: prospective evaluation of 150 consecutive patients with 2-years followup . Clin Orthop Relat Res . 2013 ; 471 ( 7 ): 2296 – 2302 . Crossref , PubMed Google Scholar
167. van Laarhoven SN , Heesterbeek PJC , Teerenstra S , Wymenga AB . Revision for coronal malalignment will improve functional outcome up to 5 years postoperatively . Knee Surg Sports Traumatol Arthrosc . 2022 ; 30 ( 8 ): 2731 – 2737 . Crossref , PubMed Google Scholar
168. van Rensch PJH , Hannink G , Heesterbeek PJC , Wymenga AB , van Hellemondt GG . Long-Term Outcome Following Revision Total Knee Arthroplasty is Associated With Indication for Revision . J Arthroplasty . 2020 ; 35 ( 6 ): 1671 – 1677 . Crossref , PubMed Google Scholar
169. Verbeek JFM , Hannink G , Defoort KC , Wymenga AB , Heesterbeek PJC . Age, gender, functional KSS, reason for revision and type of bone defect predict functional outcome 5 years after revision total knee arthroplasty: a multivariable prediction model . Knee Surg Sports Traumatol Arthrosc . 2019 ; 27 ( 7 ): 2289 – 2296 . Crossref , PubMed Google Scholar
170. Wang C-J , Hsieh M-C , Huang T-W , Wang J-W , Chen H-S , Liu C-Y . Clinical outcome and patient satisfaction in aseptic and septic revision total knee arthroplasty . Knee . 2004 ; 11 ( 1 ): 45 – 49 . Crossref , PubMed Google Scholar
171. Watts CD , Wagner ER , Houdek MT , et al. Morbid obesity: a significant risk factor for failure of two-stage revision total knee arthroplasty for infection . J Bone Joint Surg Am . 2014 ; 96 ( 18 ): e154 . Crossref , PubMed Google Scholar
172. Watts CD , Wagner ER , Houdek MT , Lewallen DG , Mabry TM . Morbid Obesity: Increased Risk of Failure After Aseptic Revision TKA . Clin Orthop Relat Res . 2015 ; 473 ( 8 ): 2621 – 2627 . Crossref , PubMed Google Scholar
173. Wilson JM , Farley KX , Erens GA , Bradbury TL , Guild GN . Preoperative Depression Is Associated With Increased Risk Following Revision Total Joint Arthroplasty . J Arthroplasty . 2020 ; 35 ( 4 ): 1048 – 1053 . Crossref , PubMed Google Scholar
174. Wilson JM , Farley KX , Bradbury TL , Erens GA , Guild GN . Preoperative opioid use is a risk factor for complication and increased healthcare utilization following revision total knee arthroplasty . Knee . 2020 ; 27 ( 4 ): 1121 – 1127 . Crossref , PubMed Google Scholar
175. Winther SB , Snorroeggen GL , Klaksvik J , et al. The indication for aseptic revision TKA does not influence 1-year outcomes: an analysis of 178 full TKA revisions from a prospective institutional registry . Acta Orthop . 2022 ; 93 : 819 – 825 . Crossref , PubMed Google Scholar
176. Xiong L , Klemt C , Yin J , Tirumala V , Kwon Y-M . Outcome of Revision Surgery for the Idiopathic Stiff Total Knee Arthroplasty . J Arthroplasty . 2021 ; 36 ( 3 ): 1067 – 1073 . Crossref , PubMed Google Scholar
177. Xu C , Wang Q , Kuo F-C , Goswami K , Tan TL , Parvizi J . The Presence of Sinus Tract Adversely Affects the Outcome of Treatment of Periprosthetic Joint Infections . J Arthroplasty . 2019 ; 34 ( 6 ): 1227 – 1232 . Crossref , PubMed Google Scholar
178. Yapp LZ , Walmsley PJ , Moran M , Clarke JV , Simpson A , Scott CEH . The effect of hospital case volume on re-revision following revision total knee arthroplasty . Bone Joint J . 2021 ; 103-B ( 4 ): 602 – 609 . Crossref , PubMed Google Scholar
179. Yapp LZ , Clement ND , Moran M , Clarke JV , Simpson A , Scott CEH . Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty: 107,121 patients from the Scottish Arthroplasty Project . Bone Joint J . 2022 ; 104-B ( 1 ): 45 – 52 . Crossref , PubMed Google Scholar
180. No authors listed . Pre-operative prognostic factors for outcomes of revision total knee arthroplasty: a mapping review . https://maartjebelt.shinyapps.io/review_app/ ( date last accessed 23 April 2023 ). Google Scholar
181. Sanchez-Santos MT , Garriga C , Judge A , et al. Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery . Sci Rep . 2018 ; 8 ( 1 ): 3381 . Crossref , PubMed Google Scholar
182. Shim J , Mclernon DJ , Hamilton D , Simpson HA , Beasley M , Macfarlane GJ . Development of a clinical risk score for pain and function following total knee arthroplasty: results from the trin study . Rheumatol Adv Pract . 2018 ; 2 ( 2 ): rky021 . Crossref , PubMed Google Scholar
183. Huber M , Kurz C , Leidl R . Predicting patient-reported outcomes following hip and knee replacement surgery using supervised machine learning . BMC Med Inform Decis Mak . 2019 ; 19 ( 1 ): 3 . Crossref , PubMed Google Scholar
184. Goodman SM , Mehta B , Mirza SZ , et al. Patients’ perspectives of outcomes after total knee and total hip arthroplasty: a nominal group study . BMC Rheumatol . 2020 ; 4 : 3 . Crossref , PubMed Google Scholar
185. Räsänen P , Paavolainen P , Sintonen H , et al. Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs . Acta Orthop . 2007 ; 78 ( 1 ): 108 – 115 . Crossref , PubMed Google Scholar
186. Konopka JF , Lee Y-Y , Su EP , McLawhorn AS . Quality-Adjusted Life Years After Hip and Knee Arthroplasty: Health-Related Quality of Life After 12,782 Joint Replacements . JB JS Open Access . 2018 ; 3 ( 3 ): e0007 . Crossref , PubMed Google Scholar
187. Masselin-Dubois A , Attal N , Fletcher D , et al. Are psychological predictors of chronic postsurgical pain dependent on the surgical model? A comparison of total knee arthroplasty and breast surgery for cancer . J Pain . 2013 ; 14 ( 8 ): 854 – 864 . Crossref , PubMed Google Scholar
188. Smith PD , Becker K , Roberts L , Walker J , Szanton SL . Associations among pain, depression, and functional limitation in low-income, home-dwelling older adults: An analysis of baseline data from CAPABLE . Geriatr Nurs . 2016 ; 37 ( 5 ): 348 – 352 . Crossref , PubMed Google Scholar
189. Ponkilainen VT , Uimonen M , Raittio L , Kuitunen I , Eskelinen A , Reito A . Multivariable models in orthopaedic research: a methodological review of covariate selection and causal relationships . Osteoarthritis Cartilage . 2021 ; 29 ( 7 ): 939 – 945 . Crossref , PubMed Google Scholar
Author contributions
M. Belt: Conceptualization, Data curation, Formal analysis, Visualization, Writing – original draft, Writing – review & editing.
B. Robben: Data curation,Visualization, Writing – review & editing.
J. M. Smolders: Conceptualization, Visualization, Writing – review & editing.
B. W. Schreurs: Conceptualization, Visualization, Writing – review & editing.
G. Hannink: Conceptualization, Visualization, Writing – review & editing.
K. Smulders: Conceptualization, Visualization, Writing – review & editing.
Funding statement
This study received funding from Smith & Nephew to provide the authors with research support for staff. Smith & Nephew had no role in the design and conduct of the study.
ICMJE COI statement
This study received funding from Smith & Nephew to provide the authors with research support for staff. Smith & Nephew had no role in the design and conduct of the study. Separately, W. Schreurs declares being past president and board of the European Hip Society (2014 to 2021), which is unrelated to this work. J. M. H. Smolders reports preparation of a medical education module and faculty at a course and conference from Smith & Nephew, which is also unrelated.
Data sharing
The data for this study are publicly available at https://maartjebelt.shinyapps.io/review_app/
Open access funding
This study received funding from Smith & Nephew to provide the authors with research support for staff. Smith & Nephew had no role in the design and conduct of the study.
Follow M. Belt @maartjebelt
Supplementary material
Search strategy per database, and tables of prognostic factor and outcome categories.
© 2023 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
