FUNCTIONAL OUTCOME FOLLOWING RE REVISION TOTAL KNEE ARTHROPLASTY – RESULTS AT 3 TO 5 YEARS

Abstract

Introduction: As the age for performing a primary knee replacement is gradually falling there is increase need and demand for revision total knee replacement and subsequent revisions thereafter. There are very few published studies showing the outcome of re revision knee replacement surgery.

Aim: We aim to show functional outcome of 21 patients at 3 to 5 years after undergoing Re revision knee arthroplasty.

Methods: We defined re revision as a procedure where there was exchange of either one or both Tibial and Femoral components using a modular revision system. We included all patients undergoing re revision knee replacement and had complete records & X rays . We excluded patients with incomplete records, those who could not be assessed due to medical infirmity or other reasons. We also excluded patients with 2 stage revision knee replacement for infection. This left us with 21 patients in our cohort operated between 1996–2002.

The patients were scored pre operatively using Knee society score ( KSS) and Western Ontario and McMasters Osteoarthritis Index (WOMAC). Patients were assessed with same scoring system post operatively at 3 months, 1 year and annually there after. Post op x rays were reviewed by Knee society Radiological Evaluation.

Results: 18 modular revision prosthesis ( Co ordinate ultra, DePuy) and 3 rotating hinge (S Rom) prosthesis were used. The mean follow up was 3.5 years range from 11 months to 5.7 years. The mean post operative KSS score improved to 83 from pre op 41. Final post operative WOMAC scores for pain 12.3, Stiffness 5.6, Function are 47.1. We had few minor complication not requiring further surgery. Overall in 15 patients (71.43%) had a statistically significant improvement at latest follow up. 4 patients (19%) had moderate improvement and 2 patients ( 8%) had no improvement in scores.

Conclusion: We conclude that re revision knee arthroplasty provides satisfactory pain relief and knee stability. As 71% of our cohort improved significantly we continue to support the clinical use of this procedure.