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Total Knee Arthroplasty in the Post-Traumatic Knee: Revision Risks and Functional Outcomes Compared to Osteoarthritic Knees. A Report of Primary Procedures From the Dutch Arthroplasty Register.

Authors
  • Singh, Jiwanjot1
  • Rassir, Rachid1
  • Sierevelt, Inger N2
  • van Geene, Oussama F F1
  • Rademakers, Maarten V1
  • Spekenbrink-Spooren, Anneke3
  • Nolte, Peter A1
  • 1 Department of Orthopedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands. , (Netherlands)
  • 2 Department of Orthopedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands; Orthopedic Department, Xpert Clinics, Amsterdam, The Netherlands. , (Netherlands)
  • 3 Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies), s-Hertogenbosch, The Netherlands. , (Netherlands)
Type
Published Article
Journal
The Journal of arthroplasty
Publication Date
Feb 01, 2024
Volume
39
Issue
2
Pages
363–367
Identifiers
DOI: 10.1016/j.arth.2023.08.050
PMID: 37598781
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Total knee arthroplasty (TKA) for post-traumatic arthritis (PTA) poses higher challenges and increased risks of complications compared to TKA for osteoarthritis (OA). This study aimed to compare implant survivorships, reasons for revision, and patient-reported outcome measures between OA and PTA as indications for TKA. We selected all primary TKAs for PTA or OA between 2007 and 2020 from the Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies). The study included 3,897 TKA procedures for PTA (median follow-up 4.6 years; interquartile range: 2.2, 7.3) and 255,259 procedures for OA (median follow-up 4.7 years; interquartile range 2.2, 7.6). A total of 10,480 revision procedures were performed across both groups (238 in PTA knees; 10,242 in OA knees). We analyzed the prevalence of preoperative comorbidities and postoperative complications, as well as the reasons for revision, and calculated the implant survival rates. The survival revision rate in the OA group was significantly lower at both follow-up moments (5- and 10- years). The likelihood for revision was increased in TKA for PTA compared to TKA for OA (hazards ratio: 1.16 [95% confidence interval 1.02 to 1.33], P = .03). The most common reason for a revision was instability and arthrofibrosis in the PTA group compared to patellar pain for the OA group. This study demonstrated an increased risk for revision for any reason in TKA for PTA compared to OA. Revision for instability and arthrofibrosis were more prevalent in the PTA group, while revision for patellar pain was less prevalent compared to TKA for OA. Copyright © 2023 Elsevier Inc. All rights reserved.

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