Objective:

To identify predictors for the need for revision surgery within 10 years following primary total knee arthroplasty (pTKA), focusing on the radiographic assessment of osteoarthritis (OA) severity using the Kellgren-Lawrence (KL) grading system.

Approach:

• Study Design: Retrospective case-control study across two European hospitals, with ethical approval obtained from one center.
• Patient Selection: Included patients who underwent revision TKA (rTKA) within 10 years following pTKA, excluding certain criteria such as isolated patellar revision and revisions due to infection.
• Data Collection: Systematic extraction of patient data including age, BMI, sex, ASA classification, and indications for revision categorized into six types.

Key Findings:

• The volume of revision TKA is increasing more rapidly than primary TKA, with significant implications for patient outcomes and healthcare resources.
• Preoperative severity of OA, as assessed by the KL grading system, is a critical determinant of post-TKA outcomes.
• Patients with low-grade OA may experience worse clinical results and higher dissatisfaction rates post-TKA.

Interpretation:

The study aims to explore the relationship between preoperative radiographic severity of OA and the likelihood of requiring revision surgery after pTKA.

Limitations:

• The study is retrospective and conducted in two specific hospitals, which may limit generalizability.
• Exclusion criteria may have omitted relevant cases that could influence findings.

Conclusion:

Understanding the predictors for revision surgery can help improve patient care and inform healthcare policies.