Revision knee arthroplasty: Can good outcomes be achieved at lower volumes?
Knee
; 30: 63-69, 2021 Jun.
Article
in En
| MEDLINE
| ID: mdl-33873087
ABSTRACT
BACKGROUND:
The National Joint Registry (NJR) demonstrates a re-revision rate for primary knee arthroplasty of 14.2% at 7â¯years. The 2015 Getting it Right First Time (GIRFT) report highlighted that 58% of surgeons undertaking revision knee arthroplasty (RKA) performed fewer than five cases per year. It has been suggested that revision cases be centralised in specialist centres with a multidisciplinary team (MDT) approach. Such a hub and spoke or cluster models may still require revision surgery to be performed at relatively low volume units.METHODS:
An analysis of RKA surgery performed in a four surgeon, lower volume revision knee unit over 10â¯years to December 2016 was undertaken. The effect of the introduction of a MDT was reviewed. The minimum follow up was two years. The primary outcome measure was re-revision. Hospital data as well as individual surgeon NJR reports were used to ensure all re-revisions were accounted for. Outcome scores were available for 68% of cases.RESULTS:
There were 192 RKAs performed in 187 patients at a mean (stdev) of 6.3 (5.4) years from the index procedure. The mean age at surgery was 68.2 (10.9) years. Twenty nine (15.5%) patients had died at the time of final review. Twelve (6.3%) cases required a further revision procedure. The commonest complication was stiffness requiring MUA. The overall 7â¯year survivorship was 94.9% (95% CI 90.2-97.3). The mean Oxford score at 5.4â¯years was 30.4 (10.4).CONCLUSIONS:
RKA can be reliably performed at lower volume centres with appropriate MDT systems in place.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Reoperation
/
Arthroplasty, Replacement, Knee
/
Surgeons
Type of study:
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2021
Type:
Article