Primary Total Knee Arthroplasty Revised for Instability : A Detailed Registry Analysis
(2022) In Journal of Arthroplasty 37(2). p.286-297- Abstract
Background: Instability after total knee arthroplasty is a common but poorly understood complication. Methods: Data from a large national registry was used to study patient and prosthesis characteristics of 2605 total knee arthroplasty revisions for instability. The cumulative percent revision was calculated using Kaplan-Meier estimates, and Cox proportional models used to compare revision rates. The rate of further revision was analyzed with regard to prostheses used in the first revision. Results: Instability increased from 6% of all first revision procedures in 2003 to 13% in 2019. The revision risk was lower for minimally stabilized prostheses, males, and patients aged ≥65 years. Polyethylene insert exchange was used for 55% of... (More)
Background: Instability after total knee arthroplasty is a common but poorly understood complication. Methods: Data from a large national registry was used to study patient and prosthesis characteristics of 2605 total knee arthroplasty revisions for instability. The cumulative percent revision was calculated using Kaplan-Meier estimates, and Cox proportional models used to compare revision rates. The rate of further revision was analyzed with regard to prostheses used in the first revision. Results: Instability increased from 6% of all first revision procedures in 2003 to 13% in 2019. The revision risk was lower for minimally stabilized prostheses, males, and patients aged ≥65 years. Polyethylene insert exchange was used for 55% of revision procedures, using a thicker insert in 93% and a change in insert conformity in 24% of cruciate-retaining knees. The increase in either thickness or conformity had no effect on the rate of further revision. After a revision for instability, 24% had a second revision by 14 years. Recurrent instability accounted for 32% of further revisions. A lower second revision rate was seen after revision of both femoral and tibial components, and where constrained components were used. Conclusion: Revision for instability is increasing. Revising both femoral and tibial components led to a lower rate of second revision compared to a change in insert alone. Recurrent instability was common.
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- author
- Lewis, Peter L. LU ; Campbell, David G. ; Lorimer, Michelle F. ; Requicha, Francisco ; W-Dahl, Annette LU and Robertsson, Otto LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- arthroplasty, instability, knee, registry, revision
- in
- Journal of Arthroplasty
- volume
- 37
- issue
- 2
- pages
- 286 - 297
- publisher
- Elsevier
- external identifiers
-
- scopus:85119442930
- pmid:34763047
- ISSN
- 0883-5403
- DOI
- 10.1016/j.arth.2021.11.002
- language
- English
- LU publication?
- yes
- id
- bb48aba9-bc2d-49ec-af3c-b3e25f35f647
- date added to LUP
- 2021-12-13 12:07:36
- date last changed
- 2025-10-21 04:57:36
@article{bb48aba9-bc2d-49ec-af3c-b3e25f35f647,
abstract = {{<p>Background: Instability after total knee arthroplasty is a common but poorly understood complication. Methods: Data from a large national registry was used to study patient and prosthesis characteristics of 2605 total knee arthroplasty revisions for instability. The cumulative percent revision was calculated using Kaplan-Meier estimates, and Cox proportional models used to compare revision rates. The rate of further revision was analyzed with regard to prostheses used in the first revision. Results: Instability increased from 6% of all first revision procedures in 2003 to 13% in 2019. The revision risk was lower for minimally stabilized prostheses, males, and patients aged ≥65 years. Polyethylene insert exchange was used for 55% of revision procedures, using a thicker insert in 93% and a change in insert conformity in 24% of cruciate-retaining knees. The increase in either thickness or conformity had no effect on the rate of further revision. After a revision for instability, 24% had a second revision by 14 years. Recurrent instability accounted for 32% of further revisions. A lower second revision rate was seen after revision of both femoral and tibial components, and where constrained components were used. Conclusion: Revision for instability is increasing. Revising both femoral and tibial components led to a lower rate of second revision compared to a change in insert alone. Recurrent instability was common.</p>}},
author = {{Lewis, Peter L. and Campbell, David G. and Lorimer, Michelle F. and Requicha, Francisco and W-Dahl, Annette and Robertsson, Otto}},
issn = {{0883-5403}},
keywords = {{arthroplasty; instability; knee; registry; revision}},
language = {{eng}},
number = {{2}},
pages = {{286--297}},
publisher = {{Elsevier}},
series = {{Journal of Arthroplasty}},
title = {{Primary Total Knee Arthroplasty Revised for Instability : A Detailed Registry Analysis}},
url = {{http://dx.doi.org/10.1016/j.arth.2021.11.002}},
doi = {{10.1016/j.arth.2021.11.002}},
volume = {{37}},
year = {{2022}},
}