Investigation of Total Knee Arthoplasty Failure Factors and Evaluating Functional Outcomes after Revision Surgery: Total Knee Arthoplasty Failure Factors

Farhan Qazi; Abdul Waheed; Muhammad Arif; Nisar Ahmed; Nadeem Qureshi; Waqas Ali

doi:10.54393/pjhs.v5i07.1791

Authors

Farhan Qazi Department of Orthopedics, Pak International Medical College, Peshawar, Pakistan
Abdul Waheed Department of Orthopedics, Rehman Medical Institute, Peshawar, Pakistan
Muhammad Arif Department of Orthopedics, Akhtar Saeed Medical College, Rawalpindi, Pakistan
Nisar Ahmed Department of Orthopedics, Combined Military Hospital Kharian Medical College, Kharian, Pakistan
Nadeem Qureshi Department of Orthopedics, Federal Postgraduate Medical Institute, Islamabad, Pakistan
Waqas Ali Department of Orthopedics, Combined Military Hospital Kharian Medical College, Kharian, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i07.1791

Keywords:

Total Knee Arthroplasty, Aseptic Loosening, Periprosthetic Fracture, Visual Analog Scale

Abstract

Total Knee Arthroplasty (TKA) is an effective surgical procedure for treating severe knee arthritis. However, certain factors can lead to failure of TKA necessitating the revision surgery. Objective: To evaluate the factors of TKA failure along with assessment of functional outcomes after revision surgery. Methods: It was a prospective cohort study conducted at Pak International Medical College, Hayatabad, from June 2022 to July 2023. A consecutive number of 67 patients admitted in orthopedics surgery department during the selected timeframe were screened. 40 patients aged 25 years and older with Total Knee Arthroplasty (TKA) failure requiring revision surgery were included in this study. Each patient was assessed to find the causes of total knee arthroplasty failure. The American Hospital for Special Surgery Knee Score and Visual analog scale scores was used preoperatively, at three and six months after surgery to assess the functional outcomes after revision surgery. Results: The mean age of the sample was 49.2 ± 5.4years with 57.5% males and 42.5% females. The causes of failure were aseptic loosening (12.5%), periprosthetic fracture (2.5%) and patellofemoral extensor mechanism insufficiency (50%). The pre-operative (HSS) data score was 59.44 ± 5.99, at the 3-month post-operative mark 73.17 ± 3.85The mean pre-operative VAS score was determined to be 3.71 ± 0.97 and at 6-month post-operative 1.49 ± 0.79 (p-value < 0.01). Conclusions: The factors leading to failure of primary knee replacement includes patellofemoral extensor mechanism insufficiency, infection and malalignment, with revision knee surgery effectively leading to better patient outcomes.

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