J Korean Orthop Assoc.  2007 Oct;42(5):578-585. 10.4055/jkoa.2007.42.5.578.

The Methods and Results of Revision Total Knee Arthroplasty

• Cho WS
• Youm YS
• Hwang JH
• Ahn SC
• Suh JH
• Hong SH

• KMID: 2186463
• DOI: http://doi.org/10.4055/jkoa.2007.42.5.578

Abstract

PURPOSE: To suggest operative methods for revision total knee arthroplasty (TKA) according to the causes of revision surgery.
MATERIALS AND METHODS
The operative methods of 70 revision total knee arthroplasties in 64 patients between December 1996 and December 2004 were analyzed according to the causes. The mean follow-up period was 65 months (25-120 months). The range of motion and Hospital for Special Surgery (HSS) score were used for the clinical evaluation and the scoring system of American Knee Society was used for the radiographic evaluation.
RESULTS
The mean periods of revision surgery from the initial operation was 59 months (1 month-20 years). Posterior cruciate retaining prosthesis was used in 8 cases, posterior cruciate substituting prosthesis in 14 cases, and constrained type prosthesis in 48 cases. The extension stem was required in 51 cases, metal augmentation in 34 cases, and structural allograft in 15 cases for bone defect treatment and firm fixation. The average range of motion improved from 88.8o preoperatively to 105.8o at the final follow-up. HSS score also improved from 60.5 to 87.6 points. The complications after revision TKA were 3 infections (4.3%), 1 patellar dislocation (1.4%), and 1 polyethylene dislocation (1.4%).
CONCLUSION
Constrained type prostheses were needed in many cases of revision TKA. Satisfactory results were obtained using an additional structural allograft, metal augmentation, and extension stem for bone defect treatment and firm fixation.

Keyword

Knee; Revision arthroplasty; Methods

MeSH Terms

Allografts
Arthroplasty*
Dislocations
Follow-Up Studies
Humans
Knee*
Methods
Patellar Dislocation
Polyethylene
Prostheses and Implants
Range of Motion, Articular
Polyethylene

Figure

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  Fig. 1 (A) Radiograph of the right knee of a 69-year-old woman shows severe polyethylene wear and varus deformity. (B) Radiograph taken 2 years after revision surgery shows good alignment of the component with extension stems.

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  Fig. 2 (A) Radiograph of the left knee of a 72-year-old woman shows patellar dislocation. (B) Radiograph taken 6 months after revision surgery shows persistent patellar dislocation.

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