Clinical and radiographic outcomes of a hybrid fixation revision total knee arthroplasty system at short to mid-term follow-up

Knee. 2019 Jan;26(1):240-249. doi: 10.1016/j.knee.2018.11.011. Epub 2018 Dec 13.


Background: Despite the extensive study of primary arthroplasty, revision surgery is rarely discussed due to the reduced frequency and variability between patients. A new revision knee system was introduced to build off the geometry of a successful knee replacement system. This study seeks to assess the survival, clinical outcomes and radiographic assessment of this revision system at the early to mid-term.

Methods: A consecutive cohort of 234 rTKAs was identified from an institutional database. Survival analysis was assessed for aseptic loosening and any-cause failure. Patient outcome measures were the Oxford Knee Score (OKS) and patient reported satisfaction. Radiographs were assessed in accordance with the Knee Society radiographic scoring system. Mechanical alignment was assessed on three-foot standing radiographs.

Results: Aseptic survivorship at one year, two years, and five years was 100%, 100%, and 99.1%, respectively. Any-cause survival at one, two, and five years was 99.6%, 98.7%, and 92.3%, respectively. OKS improved from pre-op (average 18.8) to one year (average 31.7), two years (average 30.7), and mid-term (average 30.6) follow-up (p < 0.001 for all). At all intervals, patient satisfaction exceeded 70%. One component (0.4%) failed radiographically and was later revised. Neutral mechanical alignment was achieved in 83% of cases. In the remaining cases, alignment was in varus (10%) or valgus (seven percent). No consistent relationship between radiographs or mechanical alignment and clinical outcomes was noted.

Conclusion: The survivorship, clinical, and radiographic outcomes of the single rTKA system studied are equivalent or superior to other hybrid fixation rTKA systems reviewed in the literature at similar follow-up intervals.

Keywords: Patient satisfaction; Revision knee arthroplasty; Surgical outcomes; Survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Knee Prosthesis*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prosthesis Failure
  • Radiography / methods*
  • Reoperation / methods
  • Time Factors