Reconstructive Orthopaedics, Department of Orthopaedics, The University of British Columbia, Diamond Health Care Center, Vancouver, British Columbia, Canada.
J Arthroplasty. 2023 Jun;38(6S):S275-S280. doi: 10.1016/j.arth.2023.01.047. Epub 2023 Feb 3.
Revisions of total knee arthroplasties (TKAs) may require revision of one or both tibial and femoral components. Our purpose was to examine the clinical and functional outcomes in 1- versus 2-component TKA revisions.
We identified 92 1-component (tibial or femoral) revisions at a single center. Our inclusion criteria were isolated revision of the tibial or femoral components with a minimum 2-year follow-up. The included cases were matched 1:2 with a control group of 2-component revisions (tibial and femoral) by age, body mass index, American Society of Anesthesiologists score, and indication for revision. We collected demographics, complications, operative times, any subsequent rerevisions, and functional outcome scores.
The median follow-up time for the 1- and 2-component revision groups were 10 years (range, 3 to 17) and 8 years (range, 2 to 18), respectively. The most common complication after rerevision in both groups was stiffness at 9 of 92 (9.8%) and 9 of 170 (5.3%) in the 1- and 2-component groups, respectively (P = .20). The overall complication prevalence in the 1- and 2- component revision groups was similar 20 of 92 (22%) and 35 of 170 (21%), respectively (P = .87). Subsequent rerevisions for any indication were encountered in 12 of 92 (13.0%) of the 1-component and 18 of 170 (11%) in the 2-component groups (P = .69). There was no statistical difference in survivorship or functional outcomes scores between the groups.
Our results showed that isolated revision of a single TKA component is an acceptable option, with comparable functional outcomes, complications, and survivorships when compared with both-component revision. As such, a 1-component revision should be considered where appropriate.
全膝关节置换术（TKA）的翻修可能需要对一个或两个胫骨和股骨部件进行翻修。我们的目的是研究单组件与双组件 TKA 翻修的临床和功能结果。
我们在一家单中心确定了 92 例单组件（胫骨或股骨）翻修。我们的纳入标准为胫骨或股骨组件的孤立性翻修，随访时间至少 2 年。符合条件的病例按年龄、体重指数、美国麻醉医师协会评分和翻修指征，与 2 组件（胫骨和股骨）对照组 1:2 匹配。我们收集了患者的人口统计学资料、并发症、手术时间、任何后续再次翻修和功能结果评分。
1 组件和 2 组件翻修组的中位随访时间分别为 10 年（范围，3 至 17 年）和 8 年（范围，2 至 18 年）。两组中最常见的再次翻修后并发症均为僵硬，分别为 92 例中的 9 例（9.8%）和 170 例中的 9 例（5.3%）（P=0.20）。1 组件和 2 组件翻修组的总体并发症发生率相似，分别为 92 例中的 20 例（22%）和 170 例中的 35 例（21%）（P=0.87）。因任何原因再次翻修的病例分别为 92 例中的 12 例（13.0%）和 170 例中的 18 例（11%）（P=0.69）。两组在生存率或功能结果评分方面无统计学差异。
我们的结果表明，单 TKA 组件的孤立性翻修是一种可接受的选择，与双组件翻修相比，具有相似的功能结果、并发症和生存率。因此，在适当情况下应考虑单组件翻修。
