title: Aseptic versus septic revision total knee arthroplasty: patient satisfaction, outcome and quality of life improvement.
abstract: We prospectively compared the clinical outcomes and patient satisfaction rates of aseptic (n=30) versus septic revision TKA (n=15) at a mean follow-up of 40 months. We hypothesized that the clinical results of septic revision TKA would be inferior to aseptic revision TKA. The indication for revision in aseptic group was stiffness in 11 patients, aseptic loosening in 13, patellar loosening or maltracking in 6 patients. Patients operated for infection had better post-operative Knee Society Scores (KSS), Function Scores and SF-36 Mental Scores than aseptic group but there were no significant differences in the satisfaction rates. Patients operated for infection had more improvement in their KSS (p=0.004) and Function Scores (p=0.02) than patients revised for stiffness. Moreover, patients operated on for patellar problems had higher satisfaction rates than patients revised for stiffness (p=0.01) or aseptic loosening (p=0.01). Thus, patients undergoing septic revision TKA had better outcomes compared to those with aseptic revision TKA. However, in the aseptic group, revision TKA for stiffness was associated with the poorest outcomes. The indication for aseptic revision is an important variable when discussing treatment and outcome with patients.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA. drnileshpatil7@gmail.com
authors.forename: Nilesh
authors.initials: N
authors.lastname: Patil
authors.forename: Kevin
authors.initials: K
authors.lastname: Lee
authors.forename: James I
authors.initials: JI
authors.lastname: Huddleston
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Goodman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011475:Prosthesis Failure; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation / Q000534:rehabilitation; D018805:Sepsis / Q000209:etiology* / Q000534:rehabilitation / Q000601:surgery