Revision total knee arthroplasty with use of a constrained condylar knee prosthesis.
BACKGROUND
The major goals of revision total knee arthroplasty include good clinical and radiographic results with a low complication rate. A retrospective review of a case series of revision total knee arthroplasties with a constrained condylar prosthesis by a single surgeon was performed in order to ascertain the role of this prosthesis and to determine whether it provided satisfactory results.


METHODS
Ninety-seven patients (114 knees) underwent revision total knee arthroplasty with use of a constrained condylar knee prosthesis. There were eighty-four men and thirteen women. The mean age at the time of the index surgery was sixty-five years. The primary diagnosis was predominantly osteoarthritis (96%). The most common reason for revision was aseptic loosening of a component (54%). The mean time from the primary to the revision total knee arthroplasty was 6.1 years (range, six weeks to twenty-four years). The mean duration of follow-up was 7.2 years.


RESULTS
The mean Hospital for Special Surgery knee score and mean Knee Society knee and functional scores were 31, 35, and 16 points, respectively, before the operation and 83, 90, and 64 points at the time of the final follow-up. The preoperative and postoperative Western Ontario and McMaster Universities Osteoarthritis Index scores were 85 and 34.5 points, respectively. The complication rate was 9%. Five knees (4%) had a rerevision, and three knees (2.6%) had a quadriceps tendon rupture. Kaplan-Meier survivorship analysis, with revision or radiographic failure as the end point, revealed that the ten-year rate of survival of the components was 96% (95% confidence interval, 94% to 100%).


CONCLUSIONS
Revision total knee arthroplasty with use of a constrained condylar knee prosthesis had reproducible clinical success, but a complication rate of up to 9% can be expected at intermediate-term follow-up.
Kim
Young-Hoo
YH
The Joint Replacement Center of Korea, Ewha Womans University Mokdong Hospital, 911-1, Mokdong, YangChun-Ku, Seoul 158-710, South Korea. younghookim@ewha.ac.kr
Kim
Jun-Shik
JS
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis; D008297:Male; D010147:Pain Measurement; D011336:Probability; D011474:Prosthesis Design / Q000379:methods*; D011475:Prosthesis Failure; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric