Evidence map›Paper›PMID 33515323›Full record

ArticleArchives of orthopaedic and trauma surgery2021

Infection and periprosthetic fracture are the leading causes of failure after aseptic revision total knee arthroplasty.

Juliette A Meyer, Mark Zhu, Alana Cavadino, Brendan Coleman, Jacob T Munro, Simon W Young

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Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  3. Prevalence, interpretation, and management of unexpected positive cultures in revision TKA: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Juliette A MeyerSchool of Medicine, University of Auckland, Auckland, New Zealand.
Mark ZhuSchool of Medicine, University of Auckland, Auckland, New Zealand.
Alana CavadinoSchool of Medicine, University of Auckland, Auckland, New Zealand.
Brendan ColemanDepartment of Orthopaedics, Counties Manukau District Health Board, Auckland, New Zealand.
Jacob T MunroDepartment of Orthopaedics, Auckland District Health Board, Auckland, New Zealand.
Simon W YoungSchool of Medicine, University of Auckland, Auckland, New Zealand. simon.young@auckland.ac.nz.

Funding

University of Auckland Summer Student Award
6 · The paper itself

Abstract

aimThe purpose of this study was to clarify the medium to long term survival of aseptic revision total knee arthroplasty (RTKAs) and identify the common modes of failure following RTKAs. MATERIALS AND

methodsA multi-center, retrospective study included all aseptic RTKAs performed at three tertiary referral hospitals between 2003 and 2016. Patients were excluded if the revision was for prosthetic joint infection (PJI) or they had previously undergone revision surgery. Minor revisions not involving the tibial or femoral components were also excluded. Demographics, surgical data and post-operative outcomes were recorded and analyzed. Survival analysis was performed and the reasons for revision failure identified.

resultsOf 235 aseptic RTKAs identified, 14.8% underwent re-revision at mean follow-up of 8.3 years. Survivorship of RTKA was 93% at 2 years and 83% at 8 years. Average age at revision was 72.9 years (range 53-91.5). The most common reasons for failure following RTKA were periprosthetic joint infection (PJI) (40%), periprosthetic fracture (25.7%) and aseptic loosening (14.3%). Of those whose RTKA failed, the average survival was 3.33 years (8 days-11.4 years). No demographic or surgical factors were found to influence RTKA survival on univariate or multivariate analysis.

conclusionPJI and periprosthetic fracture are the leading causes of re-revision surgery following aseptic revision TKA. Efforts to improve outcomes of aseptic revision TKA should focus on these areas, particularly prevention of PJI.

Indexed as

Arthroplasty, Replacement, KneeKnee ProsthesisPeriprosthetic FracturesProsthesis-Related InfectionsSepsisAgedAged, 80 and overHumansMiddle AgedProsthesis FailureReoperationRetrospective StudiesPeriprosthetic fracturePeriprosthetic joint infectionRevision total knee arthroplasty

Identifiers

PMID33515323

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.