AB0881 COMPARISION OF FUNCTIONAL OUTCOMES BETWEEN PRIMARY AND REVISION TOTAL KNEE ARTHROPLASTY
Authors: K. Sevik, T. Ünver, B. Unver
Journal: Annals of the Rheumatic Diseases (2020)

Background: Total knee arthroplasty (TKA) is the gold-standard treatment for end-stage knee osteoarthritis (OA). An increase in the prevalance of primary and revision TKA is projected due to aging of the population, increase in the obesity and OA prevalence, patients‘ quality of life perceptions and primary TKA procedures. Although TKA reliably improves pain and function; gait ability and function are still low compared to normal levels [1]. It is important to understand the prognosis to decide to undergo a rTKA (revision total knee arthroplasty) or enhance treatment protocols [2]. Objectives: The aim of the study is to compare the functional results of primary and revision TKA. Methods: Hospital Of Special Surgery knee score (HSS), The Figure-Of-8 Walk Test (F8WT), The Modified Four Step Square Test (mFSST) and the 3-Meter Backwards Walk Test (3MBWT) were used for function assessment. Table 1. Characteristics of the patients TKA rTKA p HSS 83.00 (74.00-90.00) 78.50 (68.75-90.25) 0.179 Age-years 65.00 (57.00 – 70.25) 69.00 (59.50-75.75) 0.178 BMI-kg/cm 2 30.90 28.41 -34.65) 31.61 (25.54-36.41) 0.748 Time after surgery-years 2.00 (1.50-4.25) 3.00 (2.00-6.50) 0.038 Female 25 (80.6 %) 20 (69.0 %) 0.296 Male 6 (19.4 %) 9 (31.0 %) Pain 0.00 (0.00-0.00) 0.00 (0.00-0.75) 0.127 *p&lt;0.05 Table 2. Functional Performances Of The Patients TKA rTKA P 3MBWT 6.2 (3.80-8.69) 7.68 (6.10- 11.25) 0.042* mFSST 10.20 (9.00-12.98) 13.10 (11.25-15.07) 0.001* F8WT 6.23 (4.74-8.6) 9.11 (7.15-12.05) 0.001* *p&lt;0.05 Conclusion: Functional status, fall risk, balance and walking skills of the rTKA patients were lower than the TKA patients. rTKA patients experience longer operation time, hospital stay and make fewer functional gains. Improvement after rTKA is also reported to be lower than TKA and balance could be worsened or does not improve after TKA [2]. Walking skills of the rTKA patients were worse than the TKA patients which may cause rTKA patients to be more cautious and tentative due to fear of falling and failure of the implant leading a more impaired function [2]. rTKA patients’ balance was lower and had more fall risk than the patients with TKA. These may be due to the recurrent incision of soft tissues causing a loss of more mechanoreceptors and a greater impairment of proprioception. These findings can help clinicians to make a more informed decision for both primary and revision procedures [3]. References: [1]Jiang Y, Sanchez-Santos MT, Judge AD et al. Predictors of Patient-Reported Pain and Functional Outcomes Over 10 Years After Primary Total Knee Arthroplasty: A Prospective Cohort Study. J Arthroplasty 2017; 32: 92-100.e102. [2]Vincent KR, Vincent HK, Lee LW, Alfano AP. Inpatient rehabilitation outcomes in primary and revision total knee arthroplasty patients. Clin Orthop Relat Res 2006; 446: 201-207. [3]Wodowski AJ, Swigler CW, Liu H et al. Proprioception and knee arthroplasty: a literature review. Orthopedic Clinics 2016; 47: 301-309. Disclosure of Interests: None declared