Factors Associated with a Short-Term Revision of Total Knee Arthroplasty

Abstract

Background: To present the short-term complications that required revision surgery on total knee arthroplasty (TKAs) performed during the 2012-2013 period. Objective: To study the relation of complication appearance and type with the prosthesis model and surgical team experience. Methods: Study of patients undergoing TKA at our center between January 2012 and June 2013. Surgical teams were stratified according to the experience of the surgeon. Two different implants were utilized for this study. The following postoperative data were collected: indication for review, time of follow-up from the intervention to the indication for review (in months) and the reason for revision. A total of 322 TKAs were performed. The follow-up time from the placement of the first prosthesis was 35.48 ± 10.23 months. A revision was indicated for 60 of the 322 implanted prostheses (18.6%). The most frequent causes were aseptic loosening in 22 cases (37.9%), and anterior pain in 19 cases (32.8%). According to the prosthetic model, 11 revisions belonged to the A model (18.3%), and 49 (81%) to the B model. These results were statistically significant (p <0.001). Odds Ratio 5.78 (95% CI: 2.87-11.62). In teams with no expert in arthroplasty, the percentage of revision for instability was 8.3%; in teams with one expert, it was 4%; and in teams with two experts, it was 0%. Discussion: There is an increase in the number of reviews in knee arthroplasty surgery. The reasons for failure of total knee arthroplasty depend on several factors, including surgical techniques, implants, demographic variants, etc. The experience of the surgeon seems to influence the number of revisions. Patellofemoral kinematics also influences the evolution of total knee arthroplasty. One of the most important factors is the trochlear groove. Although the optimal troclear design has not been established. Conclusions: The prosthetic model seems to influence the survival of total knee arthroplasty. It is preferable that the surgical team always include a surgeon with expertise in knee arthroplasty.