Objectives: Clinical experience suggests that patients with osteoarthritis (OA) undergoing revision total knee arthroplasty (TKA) experience more chronic complications after surgery compared with patients receiving primary TKA. This study aimed to investigate the difference in pain, mobility, and quality of life (QoL) in patients after revision TKA compared with patients after primary TKA.
Methods: A total of 99 OA patients after revision TKA surgery and 215 patients after primary TKA surgery were investigated in a cross-sectional study using: a pain description of current pain (non-existent, mild, moderate, severe, or unbearable), the pain intensity visual analogue scale, the Knee Society Score, and the Osteoarthritis Research Society International questionnaire.
Results: Nineteen percent after primary TKA surgery and 47% after revision TKA surgery experienced severe to unbearable chronic postoperative pain. After revision TKA surgery patients reported higher pain intensities during rest (P=0.039), while walking (P=0.008), and on average over the last 24 hours (P=0.050) compared with the patients after primary TKA surgery. Patients after revision TKA surgery had reduced walking distance (P=0.001), increased use of walking aids (P=0.015), and showed an overall decreased QoL (P<0.001) compared with patients after primary TKA surgery. No significant improvement was found in walking distance (P=0.448) for patients before revision TKA surgery compared with after revision TKA surgery.
Discussion: More than twice as many patients have pain after revision surgery compared with patients after primary TKA. Patients after revision TKA surgery have reduced function, poorer QoL, and higher pain intensity compared with patients after primary TKA surgery.
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http://dx.doi.org/10.1097/AJP.0000000000000146 | DOI Listing |
J Am Acad Orthop Surg
January 2025
From the Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, USA (Sutton, Lizcano, Krueger, Courtney, and Purtill), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA (Austin).
Introduction: Clinical outcome measures used under value-based reimbursement models require risk stratification of patient demographics and medical history. Only certain perioperative patient factors may be influenced by the surgeon. The study evaluated surgeon-influenced modifiable factors associated with achieving literature-defined KOOS score thresholds to serve as the foundation of the newly established alternative payment models for total knee arthroplasties (TKA).
View Article and Find Full Text PDFPLoS One
January 2025
Department of Operating Room, Baoding First Central Hospital, Baoding, China.
The purpose of this study is to investigate the influence of kinesiophobia following Total Knee Arthroplasty (TKA) on the rehabilitation outcomes of patients during hospitalization, includes examining the trends in resting pain levels at various time points post-surgery, the trends in active flexion of the knee at various time points post-surgery, and the effects of kinesiophobia on the timing of first postoperative ambulation, the duration of postoperative hospital stay, and the results of the two-minute walk test on the day of discharge. Postoperative kinesiophobia in patients was identified using the Tampa Scale for Kinesiophobia (TSK), with 33 patients scoring >37 points and 35 patients scoring ≤37 points. Resting Pain levels were assessed using the Numerical Rating Scale (NRS) at various time points, including upon return to the ward (T1), the first (T2), second (T3), third (T4), fifth(T5) postoperative days, and the day of discharge (T6).
View Article and Find Full Text PDFOrthopadie (Heidelb)
January 2025
Endoprothesenregister Deutschland (EPRD), Berlin, Deutschland.
Objectives: To determine the influence of obesity on revision rates and mortality after primary elective hip and knee arthroplasty in Germany.
Materials And Methods: In the German Arthroplasty Registry (EPRD) there were 403,073 elective total hip arthroplasties (THA), 320,913 bicondylar total knee arthroplasties (TKA) and 48,480 unicondylar knee arthroplasties (UKA) with valid BMI available for analysis. Cumulative revision rates and 1‑year mortality was calculated for BMI groups.
Trauma Case Rep
February 2025
Department of Orthopaedic Surgery and Sports Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203, United States of America.
Introduction: Revision quadriceps tendon repair is a challenging problem. In this four-case series, novel quadriceps tendon revision resulted in improved range of motion and durable repair for patients with recurrent rupture.
Methods: Our technique includes a combination of a running locked #5 FiberWire or 2 mm SutureTape suture placed through parallel medial, lateral, and central drill holes in the patella with running Krackow-type quadriceps tendon repair medially and laterally resulting in four strands, delivering the vastus medialis and medial quadriceps tendon to an anatomic repair at the superior pole of the patella, with 2 sutures passed centrally and 1 each passed medially and laterally and then tied.
Arthroplast Today
February 2025
Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, TX, USA.
Background: Many patients require total knee arthroplasty (TKA) bilaterally; however, there is limited data on bilateral procedures. This study aims to compare medical and surgical complications and hospital-related outcomes between simultaneous and staged bilateral TKA. We hypothesize that staged procedures will have superior outcomes.
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