Bremander AB, Dunbar M, Knutson K, Petersson IF, Robertsson O.

Revision in previously satisfied knee arthroplasty patients is the result of their call on the physician, not on pre-planned follow-up:A retrospective study of 181 patients who underwent revision within 2 years

Acta Orthop. 2005 Dec;6(76):785-90

Background Degree of satisfaction with a knee arthroplasty is said to be correlated to reduced pain and better function. During a validation of the Swedish Knee Arthroplasty Register in 1997, previously operated patients were asked how satified they were with their knee. A subgroup of "satisfied" patients was identified who underwent revision within 2 years of having expressed satisfaction. Our aim was to study the revision diagnosis, to determine whether the problem leading to revision had been discovered as a result of routine follow-up, and also to find out when the symptoms leading to revision had started. Methods We retrospectively studied the medical records of 181 patients (181 knees), with a median age of 74 (31–88) years. 68% were women and the median time between primary operation and revision was 8 (3–21) years. Results Aseptic loosening (74/181) was the most common diagnosis. 2 cases were revised as a result of routine follow-up. 44% of the medical records included reports of pain in the replaced knee prior to answering the satisfaction questionnaire. Interpretation Few patients were admitted to knee revision surgery due to medical findings discovered during routine follow-up. The term "satisfaction" must be interpreted with care, as it seems to have a more complex meaning for the patients than absence of knee pain.
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