Analysis of Functional and Radiological Outcomes in Revision Total Knee Arthroplasty

Background: Revision total knee arthroplasty (rTKA) addresses failures of primary TKA, driven by infection, aseptic loosening, or instability. With rising TKA rates and projected increases in revisions, understanding functional and radiological outcomes in diverse populations is critical, particularly in regions with limited data like India.Objective: To evaluate functional and radiological outcomes of rTKA and compare morbidity and mortality between single- and two-stage procedures in an Indian cohort.Methods: This retrospective study included 66 patients undergoing rTKA at Kovai Medical Center, India (March 2022–March 2024). Functional outcomes were assessed using Hospital for Special Surgery (HSS), Knee Society (KS), and Visual Analogue Scale (VAS) scores. Radiological outcomes, including bone loss (Anderson Orthopaedic Research Institute classification) and alignment, were evaluated. Morbidity and mortality were compared using statistical analyses (p < 0.05).Results: Mean age was 65.4 years; 59.1% were female. Indications included infection (36.4%), aseptic loosening (30.3%), and instability (18.2%). HSS scores improved from 51.2 to 81.2, KS scores from 44.8 to 79.8, and VAS from 9.8 to 3.2 (all p < 0.001). Alignment improved in 80.3%, but 15.2% had radiolucent lines (p = 0.02). Two-stage procedures had higher morbidity (wound complications: 15.4% vs. 7.5%, p = 0.04; infection recurrence: 11.5% vs. 5.0%, p = 0.03).Conclusion: rTKA enhances function and alignment, but severe bone loss and two-stage procedure morbidity pose challenges, necessitating tailored strategies.