title: Reason for revision TKA predicts clinical outcome: prospective evaluation of 150 consecutive patients with 2-years followup.
abstract: BACKGROUND
  There is limited knowledge regarding the relationship between the reason for revising a TKA and the clinical outcome in terms of satisfaction, pain, and function with time.
  
  
  OBJECTIVE
  In a cohort of patients receiving a fully revised TKA, we hypothesized (1) outcomes would differ according to reason for revision at 2 years, (2) outcomes would improve gradually during those 2 years, (3) rates of complications differ depending on the reason for revision, and (4) patients with complications have lower scores.
  
  
  METHODS
  We studied a prospective cohort of 150 patients receiving a fully revised TKA using a single implant system in two high-volume centers at 24 months of followup. VAS satisfaction, VAS pain, The Knee Society Scoring System(©) (KSS) clinical and functional scores, and complication rate were correlated with their reasons for revision, including septic loosening, aseptic loosening, component malposition, instability, and stiffness.
  
  
  RESULTS
  The aseptic loosening group showed better outcomes compared with the instability, malposition, and septic loosening groups, which showed intermediate results (p < 0.05). The stiffness group performed significantly worse on all outcome measures. The outcome for patients with a complication, after treatment of the complication, was less favorable.
  
  
  CONCLUSIONS
  The reason for revision TKA predicts clinical outcomes. Satisfaction, pain reduction, and functional improvement are better and complication rates are lower after revision TKA for aseptic loosening than for other causes of failure. For component malposition, instability, and septic loosening groups, there may be more pain and a higher complication rate. For stiffness, the outcomes are less favorable in all scores.
  
  
  METHODS
  Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Sint Maartenskliniek, Nijmegen, The Netherlands.
authors.forename: Robin W T M
authors.initials: RW
authors.lastname: van Kempen
authors.forename: Janneke J P
authors.initials: JJ
authors.lastname: Schimmel
authors.forename: Gijs G
authors.initials: GG
authors.lastname: van Hellemondt
authors.forename: Hilde
authors.initials: H
authors.lastname: Vandenneucker
authors.forename: Ate B
authors.initials: AB
authors.lastname: Wymenga
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000295:instrumentation; D001530:Belgium; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
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