Abstract
Aim
Aim of the study was to find out whether patients with positive minor criteria but without meeting the MSIS definition have a difference in the outcome after revision-surgery compared to patients without any MSIS-criteria? And does the reason for revision-surgery (eg. loosening) have an additional influence on the outcome parameters in patients with positive minor criteria?
Method
A retrospective matched-pair analysis with 98 patients who had undergone revision-surgery after TJA was performed. Forty-nine patients who showed 1 to 3 positive minor criteria (PMC) whereas 49 patients without any positive minor criteria (aseptic complications control group) were compared regarding re-revision-rate and revision-free survival. Patients were matched regarding sex, age, joint and comorbidities using the classification system by McPherson et al. Reasons for revisions were categorized in loosening, body wear, periprosthetic fracture/mechanical failure and soft-tissue complication. Endpoints were defined as re-revision for any cases.
Results
In the group of patients with PMC 30.6% (n=15) had to undergo re-revision compared to 6.12% (n=3) in the true aseptic complication (AC) control group. The overall-survival in the PMC-group was 69.4% (95% CI: 47–69 months) and in the AC-group 93.9% (95% CI: 82–94 months) (p=0.001). In patients with PMC but not exchange of the implant the overall-survival was 94.1% (95%CI survival time: 71–88 months) and in comparison the cohort with exchange of the prosthesis showed an overall-survival of 56.25% (95% CI survival time: 29–53 months) (p=0.008).
Conclusions
Our findings suggest that in dependence of the occurrence of prosthetic loosening even single positive minor-criteria may have an impact on the outcome after THA- and TKA revision-surgeries.
