Revision after early aseptic failures in primary total knee arthroplasty

  • Sérgio Rocha Piedade
  • Alban Pinaroli
  • Elvire Servien
  • Philippe Neyret
Knee

Abstract

The purpose of this study was to evaluate cases of early aseptic failures presented during the first 5-year follow-up in a group of 981 primary total knee arthroplasty (primary TKA). Predisposing factors as well causes of failures and postoperative complications in different groups of aseptic failures were re-assessed and compared to a control group. A retrospective and cohort study compared one group of 944 primary TKA without surgical revision (890 patients) (Group A) with 22 primary TKA (22 patients) (Group B) that had revision TKA secondary to aseptic failure during the first five years follow-up. The cases of isolated patellar button replacement (n = 8) and infection (n = 7) were not considered in this study. All patients underwent a systematic assessment that included clinical and radiographic examinations, and IKS scores. Aseptic failure was more prevalent at the first 2-year follow-up (63%). TKA loosening (n = 11) and undiagnosed pain (n = 7) were considered the most frequent modes of failures, and laxity (n = 1) was a very rare early cause of failure. The aseptic failure group was characterized as average 5 years younger with a greater number of previous knee surgeries, lower IKS scores improvement, and more postoperative pain compared to control group, despite the fact that the aseptic failure group showed a prevalence of cases during the first 2-year follow-up. Inside this group, the undiagnosed pain group had lower improvement of IKS scores, a remarkable prevalence in prior surgical procedure (71%) and a minor mean interval between primary and revision TKA (11.6 months).

Keywords

Arthroplasty Replacement Knee Prosthesis implantation Postoperative complications Prosthesis failures Reoperation 

References

  1. 1.
    Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72Google Scholar
  2. 2.
    Baumann C, Rat AC, Osnowycz G, Mainard D, Delagoutte JP, Cuny C, Guillemin F (2006) Do clinical presentation and pre-operative quality of life predict satisfaction with care after total hip or knee replacement. J Bone Joint Surg Br 88:366–373PubMedGoogle Scholar
  3. 3.
    Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg Br 59:241–242PubMedGoogle Scholar
  4. 4.
    Bonnin M, Deschamps G, Neyret P, Chambat P (2000) Revision in non-infected total knee arthroplasty: an analysis of 69 consecutive cases. Rev Chir Orthop Reparatrice Appar Mot 86:694–706PubMedGoogle Scholar
  5. 5.
    Chakrabarty G, Newman JH, Ackroyd CE (1998) Revision of unicompartmental arthroplasty of the knee. Clinical and technical considerations. J Arthroplasty 13:191–196PubMedCrossRefGoogle Scholar
  6. 6.
    Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY (2004) Heath-related quality of life in total hip and total knee arthroplasty. A Quantitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974PubMedGoogle Scholar
  7. 7.
    Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M (2001) Early failure in total knee arthroplasty. Clin Orthop Relat Res 392:315–318PubMedCrossRefGoogle Scholar
  8. 8.
    Gustke KA (2005) Preoperative planning for revision total knee arthroplasty: avoiding chaos. J Arthroplasty 20(4 Suppl 2):37–40PubMedCrossRefGoogle Scholar
  9. 9.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  10. 10.
    Cuckler JM (2005) The infected total knee arthroplasty: management options. J Arthroplasty 20(4 Suppl 2):33–36PubMedCrossRefGoogle Scholar
  11. 11.
    Lavernia CJ, D’Apuzzo MR, Hernandez VH, Lee DJ, Rossi MD (2006) Postdischarge costs in arthroplasty surgery. J Arthroplasty 21(6 Suppl 2):144–150PubMedCrossRefGoogle Scholar
  12. 12.
    Meding JB, Keating EM, Ritter MA, Faris PM (2000) Total knee arthroplasty after high tibial osteotomy. Clin Orthop Relat Res 375:175–184PubMedCrossRefGoogle Scholar
  13. 13.
    Mihalko WM, Krackow KA (2006) Flexion and extension gap in revision total knee arthroplasty. Clin Orthop Relat Res 446:121–126PubMedCrossRefGoogle Scholar
  14. 14.
    Moreland JR, Bassett LW, Hanker GJ (1987) Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 69:745–749PubMedGoogle Scholar
  15. 15.
    Mulhall KJ, Ghomrawi HM, Scully S, Callaghan JJ, Saleh KJ (2006) Current etiologies and mode of failures in total knee arthroplasty revision. Clin Orthop Relat Res 446:45–50PubMedCrossRefGoogle Scholar
  16. 16.
    Neyret P, Deroche P, Deschamps G, Dejour H (1992) Total knee replacement after valgus osteotomy. Technical problems. Rev Chir Orthop Reparatrice Appar Mot 78:438–448PubMedGoogle Scholar
  17. 17.
    Papadopoulos EC, Parvizi J, Lai CH, Lewallen DG (2002) Total knee arthroplasty following prior distal femoral fracture. Knee 9:267–274PubMedCrossRefGoogle Scholar
  18. 18.
    Parvizi J, Hanssen AD, Spangehl MJ (2004) Total knee arthroplasty following proximal tibial osteotomy: risk factors for failures. J Bone Joint Surg Am 86:474–479PubMedGoogle Scholar
  19. 19.
    Peters CL, Hennessey R, Barden RM, Galante JO, Rosenberg AG (1997) Revision total knee arthroplasty with a cemented posterior-stabilized or constrained condylar prosthesis: a minimum 3-year and average 5-year follow-up study. J Arthroplasty 12:896–903PubMedCrossRefGoogle Scholar
  20. 20.
    Vince KG, Long W (1995) Revision knee arthroplasty: limits of press fit medullary fixation. Clin Orthop Relat Res 317:172–177PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Sérgio Rocha Piedade
    • 1
    • 2
  • Alban Pinaroli
    • 3
  • Elvire Servien
    • 3
  • Philippe Neyret
    • 3
  1. 1.Department of Orthopedics and Traumatology, School of Medical SciencesState University of Campinas, UNICAMPCampinasBrazil
  2. 2.Post Doctorate Scholarship by CNPq, National Council for Scientific and Technological DevelopmentBrasiliaBrazil
  3. 3.Departement d’Orthopedie du Genou, Centre LivetHôpital de la Croix Rousse, Hospices Civils de LyonCaluireFrance

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