Full component revision TKA yields decreased re-revision rates, increased complications

ByMax R. Wursta

Fact checked byGina Brockenbrough, MA

Key takeaways:

Full metal component revision TKA yielded decreased re-revision rates compared with liner exchange.
However, liner exchange yielded decreased complications compared with full component revision.

Revision total knee arthroplasty with full metal component revision yielded lower re-revision rates but higher complication rates compared with liner exchange revision, according to results published in the Journal of Arthroplasty.

Researchers retrospectively analyzed data from 90 patients who underwent first-time revision TKA instability from 2015 to 2019. Researchers compared re-revision rates, non-instability reoperations, 90-day readmissions and length of stay (LOS) between 42 patients who underwent isolated polyethylene liner exchange without an increase in constraint and 48 patients who underwent full femoral and tibial component revision.

OT0923Debbi_Graphic_01 — Data were derived from Debbi EM, et al. *J Arthroplasty*. 2023;doi:10.1016/j.arth.2023.09.007.

Overall re-revision rates were 14.3% for patients who underwent liner exchange and 4.2% for patients who underwent full component revision. Readmission rates were 7.1% in the liner exchange group and 4.2% in the full component revision group at 90 days.

Researchers found patients who underwent full component revision had an aseptic loosening rate of 4.2% and a periprosthetic joint infection (PJI) rate of 4.2%, while patients who underwent liner exchange had no aseptic loosening or PJI. Additionally, patients who underwent full component revision had a longer LOS (3 days) compared with patients who underwent liner exchange (1.8 days).

“In conclusion, [liner exchange] can be an effective surgical solution for TKA instability with a lower risk profile but may have an increased rate of failure of solving instability,” the researchers wrote in the study. “While [full component revision] may be a more effective solution for instability, there is possibly an increased risk of both medical and surgical complications,” they wrote.

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Source:

Debbi EM, et al. J Arthroplasty. 2023;doi:10.1016/j.arth.2023.09.007.

Disclosures: Debbi reports receiving royalties from Ortho Development; being a paid speaker or presenter for Ortho Development; being a paid consultant for DePuy Synthes; and receiving stock or stock options in Think Surgical. Please see the study for all other authors’ relevant financial disclosures.

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Full component revision TKA yields decreased re-revision rates, increased complications

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