NIH Consensus Statement on total knee replacement.

CONCLUSIONS: The success of primary TKR in most patients is strongly supported by more than 20 years of followup data. There appears to be rapid and substantial improvement in the patient's pain, functional status, and overall health-related quality of life in about 90 percent of patients; about 85 percent of patients are satisfied with the results of surgery. Short-term outcomes, as documented by functional outcome scales, are generally substantially improved after TKR. Functional outcome is improved after TKR for people across the spectrum of disability status. Technical factors in performing surgery may influence both the short- and long-term success rate. There is consensus regarding the following perioperative interventions that improve TKR outcomes: systemic antibiotic prophylaxis, aggressive postoperative pain management, perioperative risk assessment and management of medical conditions, and preoperative education. Revision TKR is done to alleviate pain and improve function. Contraindications for revision TKR include persistent infection, poor bone quality, highly limited quadriceps or extensor function, poor skin coverage, and poor vascular status. Results are not as good as with primary TKR; outcomes are better for aseptic loosening than for infections. Failed revisions require a salvage procedure (resection of arthroplasty, arthrodesis, or amputation), with inferior results compared with revision TKR. Factors related to a surgeon's case volume, technique, and choic...
Source: NIH Consensus and State of the Science Statements - Category: American Health Tags: NIH Consens State Sci Statements Source Type: research