title: Revision of the unstable total knee arthroplasty: outcome predictors.
abstract: Revision arthroplasty is often required for confirmed cases of symptomatic tibiofemoral instability after total knee arthroplasty (TKA). We evaluated the results of revision for TKA instability in a consecutive series of 67 patients (68 knees) between 2000 and 2006. Outcome measures were surgeon-based assessment of knee stability, Knee Society Score, and Short Form Health Survey 36. At an average of 39 months of follow-up, the mean Knee Society Score and Short Form Health Survey 36 physical and mental scores were 76, 53, and 67 points, respectively. Knee instability persisted in 14 patients (22%). Data at the 95% confidence level revealed that revising both the femoral and tibial components, the use of femoral augments, and smaller joint line elevation as measured on radiographs correlated significantly with achieving a stable knee. In revision surgery for TKA instability, revision of both components and the use of femoral augments seem to offer the most predictable outcome.
authors.affiliation: Rothman Institute of Orthopedics, Thomas Jefferson University,Philadelphia, Pennsylvania 19107, USA.
authors.forename: Khalid
authors.initials: K
authors.lastname: Azzam
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaufman
authors.forename: James J
authors.initials: JJ
authors.lastname: Purtill
authors.forename: Peter F
authors.initials: PF
authors.lastname: Sharkey
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Austin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome