AI Article Synopsis
- The study investigated the indication of "pain without loosening" as a reason for knee arthroplasty revisions in Danish patients, aiming to identify any hidden indications that may improve data quality in the Danish Knee Arthroplasty Register.
- A total of 104 patients were reviewed, confirming "pain without loosening" as the primary reason in 103 cases, while also uncovering 44 hidden indications like malposition of components and stiffness.
- The findings highlight that while "pain without loosening" is recognized, other significant causes need documentation in registers, with a notable concern regarding the frequency of early arthrosis grades prior to surgery possibly contributing to unexplained knee pain.
Article Abstract
Introduction: We aimed to investigate "pain without loosening" as an indication for knee arthroplasty revisions and to screen for other indications potentially hidden in this category to improve future registration and enhance data quality in the Danish Knee Arthroplasty Register.
Methods: We included 104 patients undergoing revision knee arthroplasty for the indication "pain without loosening" from 1 January 2016 to 31 December 2018 at five Danish centres. Medical records, radiographs and computed tomographies were reviewed.
Results: In 103 of 104 cases, we confirmed "pain without loosening" as an indication for revision. We found hidden indications in 44 cases; malposition of components (n = 19), stiffness (n = 13), progression of arthrosis (n = 6), instability (n = 3), liner dislocation (n = 1), residual cement (n = 1) and aseptic loosening (n = 1). The Kellgren-Lawrence arthrosis grades prior to primary knee arthroplasty were 1-2 (31%) and 3-4 (69%).
Conclusions: The indication "pain without loosening" covered patients revised due to pain, but other hidden indications were also present. Stiffness and malposition of components were hidden indications and these are not provided as indication options in the DKR and other registers. The relatively high frequency of arthrosis grade 1-2 prior to primary knee arthroplasty is concerning and may explain the occurrence of knee pain without any other pathology present.
Funding: The Danish Rheumatism Association, the Region of Southern Denmark, the Research Fund of Region Zeeland and Region of Southern Denmark, and the University of Southern Denmark.
Trial Registration: Not relevant.
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