With rising numbers of primary total knee arthroplasties, more revision total knee arthroplasties (rTKA) are being performed. Reported patient satisfaction and functional outcomes after those procedures show great variation. We reviewed satisfaction and clinical outcomes 2 years after rTKA and discuss realistic patient expectations.
Methods: We investigated a consecutive series of prospectively collated single-stage rTKAs receiving a condylar constrained, posterior stabilised or hinged revision system (LegionTM, Smith and Nephew). All surgeries were performed by two experienced arthroplasty surgeons between 2009 and 2018. Patient reported outcomes including pain, Oxford Knee Score, short form 12 and walking aid dependence were assessed preoperatively, at 3, 12 and 24 months and derived from our prospectively collected database. Satisfaction and revision rates were also recorded.
Results: The series included 80 single stage rTKA with a mean age of 69 years. At 2 years pain, knee function and mental health status significantly improved (p<0.001), however physical health status (p=0.052) and dependence upon weight-bearing walking aids (p=0.16) did not. Sixteen percent (16%) of patients returned to theatre. Overall 64% of patients were satisfied or very satisfied with the result of revision surgery.
Conclusions: Patients undergoing rTKA can be counselled to expect improvements in pain and function in the first 2 years. Quantifying outcomes in terms of their absolute values may help to set realistic expectations, which include only fair function of their knee and residual pain of around 3/10 and a 16% prevalence of return to theatre within 2 years.