Midterm clinical outcomes and survivorship of a next generation revision knee system in complex primary and revision total knee arthroplasty.

Abstract

The burden of revision total knee arthroplasty (TKA) is expected to continue to grow with the increase in the number of primary procedures performed each year. The purpose of this study was to evaluate the early clinical outcomes of a novel revision knee system for use in revision and complex primary TKA. Multicenter prospective observational cohort study of 185 patients undergoing revision TKA (rTKA) or complex primary TKA with a next generation revision knee system. Patients were separated into cohorts based on indication and combination of components. 2-year implant survivorship was examined. Clinical outcomes including Knee Society Knee Scores (KS-KS), Knee Injury and Osteoarthritis Outcomes - Joint Replacement (KOOS JR) and pain scores were compared by indication and component combinations. Most patients underwent TKA for aseptic revision (89.7%); implant survivorship at 2 years was 97.2% (95%CI 93.5-98.8) considering all indications; 97.0% (95%CI 93.0-98.7) in revision cases only. KS-KS scores improved significantly in all cohorts, with overall mean increase of 40.8 ± 22.9 points (p < 0.001). KOOS JR scores improved by 27.0 ± 20.3 (p < 0.001); pain reduction demonstrated overall mean of 3.5 ± 3.4 points (p < 0.001). Subgroup analysis of fixation method revealed no difference in KS-KS scores in uncemented approach (80.5 ± 16.4 vs 84.7 ± 14.0, p = 0.06) CONCLUSION: This revision implant system demonstrated high survival and improvement in functional outcomes after 2 years, in both the complex primary and revision TKA setting. Further study is warranted to monitor long-term results.