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Similar outcomes to primary total knee arthroplasty achievable for aseptic revision using the same primary posterior-stabilised prosthesis at a mean follow-up of 49 months

Abstract

Purpose

The aim of the study was to compare clinical and radiological outcomes between primary and aseptic revision TKAs using the same posterior-stabilised (PS) prosthesis. The authors hypothesised similar outcomes between both groups for selected patients.

Methods

This retrospective, case–control study assessed 36 patients who underwent aseptic revision TKA compared to a match group of 72 primary TKA. Both groups had the same PS design implant (ANATOMIC®, Amplitude, Valence, France). The International Knee Society (IKS) score, radiological outcomes (postoperative alignment, patellar tilt and radiolucent lines), re-intervention and revision rate were compared between the two groups with a minimum follow-up of 3 years.

Results

The final study cohort included 29 patients and 63 patients respectively in the revision and primary group, with a mean follow-up of 49.1 months (range 36.1–69). Postoperatively, there was no significant difference in IKS scores between the two groups [169.8 for the revision group and 179.6 for the primary group (p = 0.09)]. No statistical difference was observed for post-operative satisfaction 86.2% versus 92.1% (p = 0.46). Between the two groups, there was no difference in mean radiological assessment, including radiolucent lines (p = 0.7). There was no significant difference for overall implant survivorship 96.5% versus 100% (p = 0.13) at 36 months.

Conclusion

Similar clinical, radiological and survivorship outcomes were found between rTKA and primary TKA groups using the same PS level of constraint in patients undergoing revision surgery for aseptic indications at 3-year follow-up. Use of PS implants in rTKA for the correct indication suggests this to be a safe approach at least in the medium term.

Level of evidence

IV, retrospective case–control study.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not for profit sectors.

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Correspondence to S. Lustig.

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Conflict of interest

ESM, SF, HK, JS, CB: No conflict of interest; ES: institutional research support from Corin and Amplitude; SL: Royalties from Stryker and Smith Nephew, institutional research support from Corin and Amplitude.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Sappey-Marinier, E., Fratini, S., Kremer, H. et al. Similar outcomes to primary total knee arthroplasty achievable for aseptic revision using the same primary posterior-stabilised prosthesis at a mean follow-up of 49 months. Knee Surg Sports Traumatol Arthrosc 30, 2854–2861 (2022). https://doi.org/10.1007/s00167-021-06716-3

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  • DOI: https://doi.org/10.1007/s00167-021-06716-3

Keywords

  • Revision
  • Primary
  • Knee replacement
  • Posterior-stabilised
  • Outcomes
  • Survival