Improved Range of Motion and Patient-Reported Outcome Scores With Fixed-Bearing Revision Total Knee Arthroplasty for Suboptimal Axial Implant Rotation

Abstract Background Suboptimal implant rotation has consequences with respect to knee kinematics and clinical outcomes. We evaluated the functional outcomes of revision total knee arthroplasty (TKA) for poor axial implant rotation. Methods We retrospectively reviewed 42 TKAs undergoing aseptic revision for poor axial implant rotation. We assessed improvements in Knee Society Score (KSS) and final range of motion (ROM). Subgroup analyses were performed for preoperative instability and stiffness, as well as the number of components revised and level of implant constraint used. Results Revision for poor axial rotation in isolation improved KSS from 52 ± 22 to 84 ± 25 ( P P = .001). Revision in the setting of instability significantly improved the KSS ( P P = .172). Revision in the setting of stiffness significantly improved both KSS ( P P = .002). There was no statistically significant difference between the postoperative KSS ( P = .889) and final knee flexion ( P = .629) with single- or both-component revision TKA for isolated poor axial rotation or between the postoperative KSS ( P = .956) and final knee flexion ( P = .541) with or without the use of higher constraint during revision TKA for isolated poor axial rotation. Conclusion Revision TKA for poor axial alignment improves clinical outcomes scores and functional ROM.