Revision Arthroplasty for the Management of Stiffness After Primary TKA.

BACKGROUND: The aim of this study was to evaluate the results of revision surgery for the treatment of stiffness after total knee arthroplasty (TKA).

METHODS: An IRB-approved retrospective review was performed to identify patients who were revised due to stiffness after a primary TKA. Patients were included when at least one major component had to be revised due to stiffness after primary TKA with a minimum follow-up of 2 years. Patients with history of previous infection and those treated with isolated polyethylene exchange were excluded.

RESULTS: The study group involved 42 knees. Mean follow-up was 47 months (24-109 months). Mean flexion contracture improved from 9.7° (0°-35°) preoperatively to 2.3° (0°-20°) postoperatively (P < .00). Mean flexion improved from 81.5° (10°-125°) preoperatively to 94.3° (15°-140°) postoperatively (P .02). Mean range of motion improved from 72.0° preoperatively (10°-100°) to 92° (15°-140°) postoperatively (P < .00). Mean Knee Society knee scores improved from 43.9 points (15-67) preoperatively to 72.0 points (50-93) at latest follow-up and mean Knee Society Function scores improved from 48.7 (35-80) preoperatively to 70.1 points (30-90) postoperatively. Pain improved in 73% of the patients.

CONCLUSION: Revision surgery appears to be a reasonable option for patients presenting with pain and stiffness after TKA. However, the benefits may be modest as the outcomes still do not approach those achieved with primary TKA.