Patient-relevant outcomes following elective, aseptic revision knee arthroplasty: a systematic review

Systematic Reviews

Research

Lennart von Fritsch¹  Elizabeth A. Hedge¹  David J. Beard¹  Joshua Xu¹  Sally Hopewell²  Thomas W. Hamilton³  Shiraz A. Sabah³  Raja Bhaskara Rajasekaran³  Abtin Alvand³  Andrew J. Price³  Alexander D. Shearman⁴ 

[1]Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England

[2]Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England

[3]Centre for Statistics in Medicine, University of Oxford, Oxford, England

[4]Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England

[5]Nuffield Orthopaedic Centre, Oxford, England

[6]Nuffield Orthopaedic Centre, Oxford, England

关键词: Arthroplasty;    Revision/reoperation;    Total knee replacement;    Patient reported outcome measures;    Mortality;    Complications;   

DOI  :  10.1186/s13643-023-02290-6

 received in 2022-04-27, accepted in 2023-07-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe aim of this systematic review was to summarise the evidence for the clinical effectiveness of revision knee arthroplasty (rKA) compared to non-operative treatment for the management of patients with elective, aseptic causes for a failed knee arthroplasty.MethodsMEDLINE, Embase, AMED and PsychINFO were searched from inception to 1st December 2020 for studies on patients considering elective, aseptic rKA. Patient-relevant outcomes (PROs) were defined as implant survivorship, joint function, quality of life (QoL), complications and hospital admission impact.ResultsNo studies compared elective, aseptic rKA to non-operative management. Forty uncontrolled studies reported on PROs following elective, aseptic rKA (434434 rKA). Pooled estimates for implant survivorship were: 95.5% (95% CI 93.2–97.7%) at 1 year [seven studies (5524 rKA)], 90.8% (95% CI 87.6–94.0%) at 5 years [13 studies (5754 rKA)], 87.4% (95% CI 81.7–93.1%) at 10 years [nine studies (2188 rKA)], and 83.2% (95% CI 76.7–89.7%) at 15 years [two studies (452 rKA)]. Twelve studies (2382 rKA) reported joint function and/or QoL: all found large improvements from baseline to follow-up. Mortality rates were low (0.16% to 2% within 1 year) [four studies (353064 rKA)]. Post-operative complications were common (9.1 to 37.2% at 90 days).ConclusionHigher-quality evidence is needed to support patients with decision-making in elective, aseptic rKA. This should include studies comparing operative and non-operative management. Implant survivorship following elective, aseptic rKA was ~ 96% at 1 year, ~ 91% at 5 years and ~ 87% at 10 years. Early complications were common after elective, aseptic rKA and the rates summarised here can be shared with patients during informed consent.Systematic review registrationPROSPERO CRD42020196922

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3

Fig. 1

Fig. 7

Fig. 2