Comparison of Survival Rate between Posterior-Stabilized and Constrained Condylar Articulations in Revision Total Knee Arthroplasty: A Minimum 5-Year Follow-up Analysis.

BACKGROUND

Revision total knee arthroplasty (RTKA) is a technically demanding procedure for failed primary TKA. Posterior-stabilized (PS) and constrained condylar knee (CCK) articulations are commonly used for RTKA, but comparison of these articulations in RTKA is scarce. The aim of this study was to compare survival rates and clinical outcomes of RTKAs using PS articulation and CCK articulation.

METHODS

This study conducted a retrospective analysis of 86 RTKAs (PS, n = 41; CCK, n = 45) with a mean follow-up of 9.15 ± 2.79 years. Clinical outcomes were evaluated using the Hospital for Special Surgery score, Knee Society Score, and The Western Ontario and McMaster Universities Osteoarthritis Index at final follow-up. The survival rate of each group was analyzed by Kaplan-Meier survival analysis and Cox-hazard progression model.

RESULTS

Clinical outcomes were improved in both groups without significant difference. Twelve patients had orthopedic complications (4 in PS group and 8 in CCK group). Eight of them underwent re-RTKA (3 in PS group and 5 in CCK group). The articulation design did not influence the failure. The estimated 10-year survival rate was 92.7% in the PS group and 88.2% in the CCK group with no significant difference ( = 0.60). Also in septic failure, there was no significant difference in survival rate (92.7% in PS group and 92.5% in CCK group, = 0.87). The hazard ratio in the PS group was not significantly different ( = 0.607).

CONCLUSIONS

In RTKA, both PS and CCK showed similar survival rates and clinical outcomes at a mean follow-up of 9.2 years. Implant articulation did not affect the outcomes when properly indicated.