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Poorer survival after a primary implant during revision total knee arthroplasty

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Abstract

Purpose

Revision total knee arthroplasty (rTKA) is a complex procedure. Depending on the degree of ligament and bone damage, either primary or revision implants are used. The purpose of this study was to compare survival rates of primary implants with revision implants when used during rTKA.

Methods

A retrospective comparative study was conducted between 1998 and 2009 during which 69 rTKAs were performed on 65 patients. Most common indications for revision were infection (30 %), aseptic loosening (25 %) and wear/osteolysis (25 %). During rTKA, a primary implant was used in nine knees and a revision implant in 60.

Results

Survival of primary implants was 100 % at one year, 73 % [95 % confidence interval (CI) 41–100] at two years and 44 % (95 % CI 7–81) at five years. Survival of revision implants was 95 % (95 % CI 89–100) at one year, 92 % (95 % CI 84–99) at two years and 92 % (95 % CI 84–99) at five years. Primary implants had a significantly worse survival rate than revision implants when implanted during rTKA [P = 0.039 (hazard ratio = 4.56, 95 % CI 1.08–19.27)].

Conclusions

Based on these results, it has to be considered whether primary implants are even an option during rTKA.

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Conflict of interest

Drs. A.L. Boerboom is a paid consultant for Zimmer GmbH for training in knee arthroplasty and computer-assisted surgery. The department receives research institutional support from Stryker and Zimmer. The other authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Marrigje F. Meijer, Alexander L. Boerboom, Martin Stevens & Sjoerd K. Bulstra

  2. Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Inge H. F. Reininga

Authors
  1. Marrigje F. Meijer
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  2. Inge H. F. Reininga
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  3. Alexander L. Boerboom
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  4. Martin Stevens
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  5. Sjoerd K. Bulstra
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Correspondence to Marrigje F. Meijer.

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Meijer, M.F., Reininga, I.H.F., Boerboom, A.L. et al. Poorer survival after a primary implant during revision total knee arthroplasty. International Orthopaedics (SICOT) 37, 415–419 (2013). https://doi.org/10.1007/s00264-012-1739-7

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  • DOI: https://doi.org/10.1007/s00264-012-1739-7

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