Journal article
Patient reported outcome measures after revision of the infected TKR: comparison of single versus two-stage revision
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, v 21(12), pp 2713-2720
Dec 2013
PMID: 22692517
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Two-stage revision is the 'gold standard' treatment for infected total knee replacement. Single-stage revision has been successful in the hip and, in carefully chosen knee revisions, may offer the advantage of a single surgical insult with improved functional outcome.
Patient Reported Outcome Measures (PROMs) for 33 single- and 89 two-stage revisions performed for infection were analysed in combination with data from the National Joint Registry for England and Wales. Outcomes including the Oxford Knee Score (OKS), Euroqol-5D (EQ5D) and patient satisfaction were examined with the aim of investigating the following questions: does single- or two-stage revision for infection result in (1) better knee function; (2) better overall perception of health status; (3) better patient perceived success and satisfaction?
No statistical difference was found between the groups for any reported outcome measure. Mean OKS following surgery was 24.9 (95 %CI, 20.5-29.4) for single- and 22.8 (95 %CI, 20.2-25.4) for two-stage (n.s.). Mean EQ5D index following surgery was 0.495 (95 %CI, 0.357-0.632) for single and 0.473 (95 %CI, 0.397-0.548) for two-stage (n.s.). Patients reporting Excellent/Very good/Good satisfaction were similar between the groups (single = 61 % vs. two stage = 57 %, (n.s.)). In total, 66 % single- and 60 % two-stage operations were rated 'successful' (n.s.).
This study found no demonstrable benefit of single-stage compared to two-stage revision for the infected total knee replacement using a variety of PROMs. Thus, we recommend that decision making must be based on other factors such as re-infection rate.
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Details
- Title
- Patient reported outcome measures after revision of the infected TKR: comparison of single versus two-stage revision
- Creators
- Paul Baker - Newcastle UniversityTimothy G Petheram - Wansbeck General HospitalSteven Kurtz - Exponent (United States)Yrjö T Konttinen - Department of Medicine, Institute of Clinical Medicine, Helsinki (HUS), FinlandPaul Gregg - James Cook University HospitalDavid Deehan - Royal Victoria Infirmary
- Publication Details
- Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, v 21(12), pp 2713-2720
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000327084800011
- Scopus ID
- 2-s2.0-84888293484
- Other Identifier
- 991019176644804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Orthopedics
- Sport Sciences
- Surgery