Revision resurfacing knee arthroplasty for aseptic loosening

Abstract

This re-investigation presents our experience with revision resurfacing knee arthroplasty caused by aseptic failure. The evaluation of the results should elucidate the benefit of revision, its complications as well as the impact of the implant type used. The study involved 36 patients whose primary resurfacing knee prostheses failed by aseptic loosening. The rather elderly patients (average 68.3 years) underwent revision 6 years later on average. In 30 cases (83.3%), arthroplasty could be repeated with resurfacing implants, whereas the use of hinge prostheses was unavoidable in 6 knees (16.7%). After an average of 7 years later, 30 knees were re-investigated according to the Hospital for Special Surgery (HSS) scoring system. Results were compared with the HSS values prior to revision. Complications and revised implant survivorship were reported chronologically. The revision knees had a 80% incidence of improved HSS score. In 73.3% the outcome was graded as good or even excellent. In contrast, scoring values before revision were dissatisfying without exception. The early complication rate after operation was 25%. Persisting pain, instability and limited mobility led to repeated revision in two cases and arthrodesis of one of the knees. The outcome of revision after 7 years revealed a remarkable early complication rate. Nevertheless, good or excellent results could be scored after implantation of PFC, PFC-modular, TC and TCIII prostheses.