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Factors Associated with a Short-Term Revision of Total Knee Arthroplasty

Received: 25 October 2018     Accepted: 13 November 2018     Published: 19 December 2018
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Abstract

Background: To present the short-term complications that required revision surgery on total knee arthroplasty (TKAs) performed during the 2012-2013 period. Objective: To study the relation of complication appearance and type with the prosthesis model and surgical team experience. Methods: Study of patients undergoing TKA at our center between January 2012 and June 2013. Surgical teams were stratified according to the experience of the surgeon. Two different implants were utilized for this study. The following postoperative data were collected: indication for review, time of follow-up from the intervention to the indication for review (in months) and the reason for revision. A total of 322 TKAs were performed. The follow-up time from the placement of the first prosthesis was 35.48 ± 10.23 months. A revision was indicated for 60 of the 322 implanted prostheses (18.6%). The most frequent causes were aseptic loosening in 22 cases (37.9%), and anterior pain in 19 cases (32.8%). According to the prosthetic model, 11 revisions belonged to the A model (18.3%), and 49 (81%) to the B model. These results were statistically significant (p <0.001). Odds Ratio 5.78 (95% CI: 2.87-11.62). In teams with no expert in arthroplasty, the percentage of revision for instability was 8.3%; in teams with one expert, it was 4%; and in teams with two experts, it was 0%. Discussion: There is an increase in the number of reviews in knee arthroplasty surgery. The reasons for failure of total knee arthroplasty depend on several factors, including surgical techniques, implants, demographic variants, etc. The experience of the surgeon seems to influence the number of revisions. Patellofemoral kinematics also influences the evolution of total knee arthroplasty. One of the most important factors is the trochlear groove. Although the optimal troclear design has not been established. Conclusions: The prosthetic model seems to influence the survival of total knee arthroplasty. It is preferable that the surgical team always include a surgeon with expertise in knee arthroplasty.

Published in Journal of Surgery (Volume 6, Issue 6)
DOI 10.11648/j.js.20180606.14
Page(s) 162-166
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Revision, Total Knee Arthroplasty, Prothesis Model, Surgical Team Experience

References
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Cite This Article
  • APA Style

    Gómez Cáceres Abel, Carnero Martín de Soto Pablo, Fernández de Arróyabe Sáez de Ojer Naiara, Montes Molinero David, Aguiar García Francisco, et al. (2018). Factors Associated with a Short-Term Revision of Total Knee Arthroplasty. Journal of Surgery, 6(6), 162-166. https://doi.org/10.11648/j.js.20180606.14

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    ACS Style

    Gómez Cáceres Abel; Carnero Martín de Soto Pablo; Fernández de Arróyabe Sáez de Ojer Naiara; Montes Molinero David; Aguiar García Francisco, et al. Factors Associated with a Short-Term Revision of Total Knee Arthroplasty. J. Surg. 2018, 6(6), 162-166. doi: 10.11648/j.js.20180606.14

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    AMA Style

    Gómez Cáceres Abel, Carnero Martín de Soto Pablo, Fernández de Arróyabe Sáez de Ojer Naiara, Montes Molinero David, Aguiar García Francisco, et al. Factors Associated with a Short-Term Revision of Total Knee Arthroplasty. J Surg. 2018;6(6):162-166. doi: 10.11648/j.js.20180606.14

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  • @article{10.11648/j.js.20180606.14,
      author = {Gómez Cáceres Abel and Carnero Martín de Soto Pablo and Fernández de Arróyabe Sáez de Ojer Naiara and Montes Molinero David and Aguiar García Francisco and García de Quevedo Puerta David},
      title = {Factors Associated with a Short-Term Revision of Total Knee Arthroplasty},
      journal = {Journal of Surgery},
      volume = {6},
      number = {6},
      pages = {162-166},
      doi = {10.11648/j.js.20180606.14},
      url = {https://doi.org/10.11648/j.js.20180606.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180606.14},
      abstract = {Background: To present the short-term complications that required revision surgery on total knee arthroplasty (TKAs) performed during the 2012-2013 period. Objective: To study the relation of complication appearance and type with the prosthesis model and surgical team experience. Methods: Study of patients undergoing TKA at our center between January 2012 and June 2013. Surgical teams were stratified according to the experience of the surgeon. Two different implants were utilized for this study. The following postoperative data were collected: indication for review, time of follow-up from the intervention to the indication for review (in months) and the reason for revision. A total of 322 TKAs were performed. The follow-up time from the placement of the first prosthesis was 35.48 ± 10.23 months. A revision was indicated for 60 of the 322 implanted prostheses (18.6%). The most frequent causes were aseptic loosening in 22 cases (37.9%), and anterior pain in 19 cases (32.8%). According to the prosthetic model, 11 revisions belonged to the A model (18.3%), and 49 (81%) to the B model. These results were statistically significant (p <0.001). Odds Ratio 5.78 (95% CI: 2.87-11.62). In teams with no expert in arthroplasty, the percentage of revision for instability was 8.3%; in teams with one expert, it was 4%; and in teams with two experts, it was 0%. Discussion: There is an increase in the number of reviews in knee arthroplasty surgery. The reasons for failure of total knee arthroplasty depend on several factors, including surgical techniques, implants, demographic variants, etc. The experience of the surgeon seems to influence the number of revisions. Patellofemoral kinematics also influences the evolution of total knee arthroplasty. One of the most important factors is the trochlear groove. Although the optimal troclear design has not been established. Conclusions: The prosthetic model seems to influence the survival of total knee arthroplasty. It is preferable that the surgical team always include a surgeon with expertise in knee arthroplasty.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Factors Associated with a Short-Term Revision of Total Knee Arthroplasty
    AU  - Gómez Cáceres Abel
    AU  - Carnero Martín de Soto Pablo
    AU  - Fernández de Arróyabe Sáez de Ojer Naiara
    AU  - Montes Molinero David
    AU  - Aguiar García Francisco
    AU  - García de Quevedo Puerta David
    Y1  - 2018/12/19
    PY  - 2018
    N1  - https://doi.org/10.11648/j.js.20180606.14
    DO  - 10.11648/j.js.20180606.14
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 162
    EP  - 166
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180606.14
    AB  - Background: To present the short-term complications that required revision surgery on total knee arthroplasty (TKAs) performed during the 2012-2013 period. Objective: To study the relation of complication appearance and type with the prosthesis model and surgical team experience. Methods: Study of patients undergoing TKA at our center between January 2012 and June 2013. Surgical teams were stratified according to the experience of the surgeon. Two different implants were utilized for this study. The following postoperative data were collected: indication for review, time of follow-up from the intervention to the indication for review (in months) and the reason for revision. A total of 322 TKAs were performed. The follow-up time from the placement of the first prosthesis was 35.48 ± 10.23 months. A revision was indicated for 60 of the 322 implanted prostheses (18.6%). The most frequent causes were aseptic loosening in 22 cases (37.9%), and anterior pain in 19 cases (32.8%). According to the prosthetic model, 11 revisions belonged to the A model (18.3%), and 49 (81%) to the B model. These results were statistically significant (p <0.001). Odds Ratio 5.78 (95% CI: 2.87-11.62). In teams with no expert in arthroplasty, the percentage of revision for instability was 8.3%; in teams with one expert, it was 4%; and in teams with two experts, it was 0%. Discussion: There is an increase in the number of reviews in knee arthroplasty surgery. The reasons for failure of total knee arthroplasty depend on several factors, including surgical techniques, implants, demographic variants, etc. The experience of the surgeon seems to influence the number of revisions. Patellofemoral kinematics also influences the evolution of total knee arthroplasty. One of the most important factors is the trochlear groove. Although the optimal troclear design has not been established. Conclusions: The prosthetic model seems to influence the survival of total knee arthroplasty. It is preferable that the surgical team always include a surgeon with expertise in knee arthroplasty.
    VL  - 6
    IS  - 6
    ER  - 

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Author Information
  • Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain

  • Arthrosport Zaragoza, Pilar Clinic, Zaragoza, Spain

  • Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain

  • Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain

  • Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain

  • Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain

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