Performance-based Functional Outcomes After Primary vs Predominantly Septic First-time Revision TKA.

BACKGROUND

Total knee arthroplasty (TKA) outcomes are mainly assessed using radiographic and clinical survival analysis. Recently, several studies have been published on patient-reported outcome measures. However, data on functional performance differences between primary and revision TKA (rTKA) are limited. The study aims to compare the functional performance of primary and revision TKA.

PATIENTS/

METHODS

Twenty-nine patients with primary TKA and rTKA were included in this study. Patients completed the performance-based tests of the 3-meter Backwards Walk Test (3MBWT), the modified Four Square Step Test (mFSST), and the Figure-of-Eight Walk Test (F8WT). Their pain levels and the Hospital for Special Surgery (HSS) knee scores were determined.

RESULTS

Age, gender, body mass index, time after surgery, pain level, and HSS scores were similar across groups. Surgery in the rTKA group was predominantly indicated for sepsis (26/29). The 3MBWT, mFSST, and F8WT scores of the rTKA patients were lower than those of patients who had primary TKA (p < 0.05).

DISCUSSION: The functional performances related to fall risk, dynamic balance, stepping, and various walking skills after predominantly septic first-time rTKA were poorer than after primary TKA, with medium effect sizes. These results offer patients realistic expectations after TKA and rTKA, predominantly septic first-time rTKA. Clinicians and patients should make additional efforts to improve the durability of the primary operation and reduce the need for future revision surgery. Additionally, rTKA patients may require more intensive, comprehensive rehabilitation programs.