Bone Defects in Revision Total Knee Arthroplasty and Management.

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Abstract

[Indexed for MEDLINE] 9. J Knee Surg. 2025 Oct;38(12):626-631. doi: 10.1055/a-2608-0053. Epub 2025 May 14. Revision Total Knee Arthroplasty for Mid-Flexion or Combined Mid-Flexion and Flexion Instability: Survivorship and Outcomes. Cohen JS(1), Thota PK(1), Pei YA(1), Sheth NP(1). Author information: (1)Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. As patients place higher demand on their implants, mid-flexion instability is increasingly recognized as a contributor to dissatisfaction after total knee arthroplasty (TKA). However, the outcomes of revision surgery to address mid-flexion instability have not been categorized. The study cohort was composed of 52 patients who underwent revision surgery for mid-flexion or combined flexion and mid-flexion instability by a single surgeon between 2015 and 2022. The mean follow-up duration was 2.76 years. Patient characteristics, implants used, and complications were recorded. Range of motion and patient-reported outcomes (collected using the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement [KOOS Jr.] and EuroQol-5 Dimensions-5 Levels [EQ-5D-5L] questionnaires) were compared before surgery and at final follow-up. Five patients (9.6%) required an additional operation. Causes of reoperations included component loosening, persistent wound drainage, recurrent instability, and arthrofibrosis. KOOS Jr. scores improved from 46 preoperatively to 60 postoperatively (p