Causes and Clinical Outcomes Associated with Re-revision Total Knee Arthroplasty

Bae, Dae Kyung; Yoon, Kyoung Ho; Song, Sang Jun; Noh, Jung Ho; Kim, Man Ho

Abstract

PURPOSE: To analyze the causes and clinical outcomes associated with re-revision total knee arthroplasty.
MATERIALS AND METHODS
Eighteen cases of re-revision total knee arthroplasty (TKA) were performed between June 1996 and September 2006. The average patient age was 69.8 years, and the average follow-up period was 3.4 years. We evaluated the time interval between revision and re-revision arthroplasty and the causes of re-revision. Clinical outcomes were assessed using the Hospital for Special Surgery (HSS) knee rating score and determining the range of motion in the knee.
RESULTS
The mean interval between revision and re-revision arthroplasty was 9 years 1 month. Causes of re-revision included 9 cases of polyethylene wear, 6 cases of aseptic loosening, 1 case of infection, and 2 cases of other causes. The average HSS score was 89.1, and the average range of motion was 111.1 degrees. For 5 cases of revision undertaken secondary to infected TKA, the interval between revision and re-revision arthroplasty was 9 years 3 months, and the cause of re-revision surgery was aseptic loosening in all cases.
CONCLUSION
The main causes of re-revision surgery were polyethylene wear and aseptic loosening. Reasonable restoration of function was achieved in re-revision arthroplasty using appropriately selected implants, metal augmentation, structural allografts, and stems. When revising an infected TKA, it is important to achieve structural stability in the implant because of the possibility of late aseptic loosening.