Complications of revision knee arthroplasty

Authors

DOI:

https://doi.org/10.14739/2310-1210.2024.4.298245

Keywords:

knee joint, knee joint instability, revision arthroplasty

Abstract

Due to the growing scale of arthroplasty and the widening of indications for knee joint replacement, the durability of joint functioning has become a critical issue. Untimely diagnosis and inadequate treatment of patients with endoprosthesis component loosening leads to major bone defects.

This problem arises from repeated joint interventions, large bone defects and duration of revision surgeries, that is fraught with catastrophic consequences for patients – revision prosthesis removal or even limb amputation. The project aims to improve the treatment for patients with instability of components after knee joint arthroplasty.

The aim of the study is to analyze the results of revision knee arthroplasty and identify the causes of mistakes and complications of revision arthroplasty with the intention of prevention.

Materials and methods. A retrospective analysis of 50 revision knee arthroplasties performed at the Centre for Arthroplasty of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” was conducted. Clinical and radiological findings were evaluated for all patients. All revision prostheses used in this study were of the semi-constrained type. Cementation technique was used for all implants. In the revision of the septic complication group, a full cementation technique with antibiotics according to a sensitivity profile were used, while in the aseptic complication group, a surface cementation technique with antibiotics according to sensitivities were used.

Results. The authors of the project have analyzed the results of treatment of 50 revision arthroplasty procedures performed between 2013 and 2022 for instability of the endoprosthesis components. The structure of complications has been examined and the causes of failure in revision knee arthroplasty have been identified. This study has shown promise in preventing complications and developing personalized approaches to revision arthroplasty.

Conclusions. The analysis of revision knee arthroplasty failure has shown the prevalence of septic complications (56.0 %). In the case of septic complications after revision arthroplasty, Staphylococcus aureus prevailed (57.1 %), gram (-) microorganisms were causative agents in other cases. Factors resulting in aseptic complications included those associated with the surgical intervention (81.8 %), the patient (45.4 %) and the combination thereof (72.7 %). Significant causes of the femoral revision component loosening were residual valgus deformity, medial instability in the frontal plane; significant causes of the tibial component loosening were residual varus deformity and lateral instability in the frontal plane.

Author Biographies

H. V. Haiko, State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, DSc, Professor, Head of the Department of Traumatology and Orthopedics of Adults, Academician of the National Academy of Medical Sciences of Ukraine

V. M. Pidhaietskyi, State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Traumatology and Orthopedics of Adults

O. M. Sulyma, State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Traumatology and Orthopedics of Adults

V. M. Chornyi, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, DSc, Professor of the Department of Traumatology and Orthopedics

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Published

2024-07-17

How to Cite

1.
Haiko HV, Pidhaietskyi VM, Sulyma OM, Chornyi VM. Complications of revision knee arthroplasty. Zaporozhye Medical Journal [Internet]. 2024Jul.17 [cited 2025Jan.15];26(4):288-95. Available from: http://zmj.zsmu.edu.ua/article/view/298245

Issue

Vol. 26 No. 4 (2024): Zaporozhye medical journal

Section

Original research

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