Abstract
Aim: To prospectively determine the functional outcome of revision total knee replacement (TKR).
Method: We carried out a prospective outcome study recruiting 65 consecutive revision total knee replacements carried out by the senior author between 1992 and 1995. The indications for revision were aseptic loosening in 40 cases, instability in 7, infection in 4, and 16 cases for other causes. All patient was assessed preoperatively and at 3 and 12 months postop using the Nottingham Health Profile (NHP) to measure general health status. As part of this ongoing study, followup data is available for 24 patient at 5 years.
Results: There were 65 revisions in 60 patients, 5 being bilateral. There were 37 females and 23 males, with a mean age of 63 years (range 29 to 86 years). The preoperative scores showed that the patient had significant disability related to their failed TKR. Three months postop, there was a significant improvement in the NHP scores for pain and social isolation. At 12 months, the level of pain was again significantly improved over the 3 month score.
At 5 years, the pain score for the revision group deteriorated but remained better than the baseline level. This is in contrast to post primary TKR, where the improvement in pain score was maintained from 3 months onwards.
Conclusion: This study shows a significant improvement in the level of pain following revision knee arthroplasty. However, patients remain significantly disabled afterwards and do not show the very marked improvement in general health seen after primary TKR.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
