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- Title
Age, gender, functional KSS, reason for revision and type of bone defect predict functional outcome 5 years after revision total knee arthroplasty: a multivariable prediction model.
- Authors
Verbeek, Jan F. M.; Hannink, Gerjon; Defoort, Koen C.; Wymenga, Ate B.; Heesterbeek, Petra J. C.
- Abstract
<bold>Purpose: </bold>The number of revision total knee arthroplasties (rTKA) is increasing. Unfortunately, not all patients benefit from revision surgery. The aim of this study was to develop a clinical prediction model that can be used to predict the functional outcome 5 years after rTKA.<bold>Methods: </bold>Data of patients receiving rTKA at Sint Maartenskliniek, Nijmegen, The Netherlands, from 2004 onwards were prospectively collected. Demographic and clinical variables and patient-reported outcome scores were collected and considered as potential predictors. Beneficial outcome was defined as an increase of ≥ 20 points on the functional knee society scores (fKSS) or an absolute fKSS ≥ 80 points 5 years after surgery. The prediction model was developed using backward logistic regression. Regression coefficients were converted into an easy to use prediction rule.<bold>Results: </bold>Overall, 295 rTKA patients were included of whom 157 (53%) had beneficial fKSS 5 years later. Age, gender, femoral bone defects, preoperative fKSS, and stiffness as reason for revision were included in the model. Men had a higher chance of beneficial fKSS than women (OR 1.59, 95% CI 0.91-2.78). Patients with major bone defects (OR 0.44, 95% CI 0.22-0.85), higher age (IQR OR 0.39, 95% CI 0.26-0.58), higher preoperative fKSS (IQR OR 0.42, 95% CI 0.30-0.59), and severe stiffness (OR 0.48, 95% CI 0.20-1.15) had a lower chance of successful outcome. The model's AUC was 0.76, 95% CI 0.70-0.81.<bold>Conclusion: </bold>Easily determinable characteristics of patients who need rTKA can be used to predict future functional outcome. Young men with low preoperative fKSS without severe stiffness are more likely to achieve a beneficial outcome.<bold>Level Of Evidence: </bold>IV.
- Subjects
NETHERLANDS; TOTAL knee replacement reoperation; TOTAL knee replacement; MEDICAL function tests; KNEE surgery; ARTHROPLASTY; REOPERATION; FEMUR surgery; CONVALESCENCE; LONGITUDINAL method; STATISTICAL models
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 7, p2289
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05365-x