Revision of both femoral and tibial components of a total knee arthroplasty (TKA) for aseptic loosening has favorable outcomes. Revision of only one loose component with retention of others has shorter operative time and lower cost; however, implant survivorship and clinical outcomes of these different operations are unclear. Between January 2009 and December 2019, a consecutive cohort of revision TKA was reviewed. Univariate and multivariable analyses were used to study correlations among factors and surgical related complications, time to prosthesis failure, and functional outcomes (University of California Los Angeles, Knee Society functional, knee osteoarthritis and outcome score for joint replacement, Veterans RAND 12 (VR-12) physical, and VR-12 mental). A total of 238 patients underwent revision TKA for aseptic loosening. The mean follow-up time was 61 months (range 25 to 152). Ten of the 105 patients (9.5%) who underwent full revision (both femoral and tibial components) and 18 of the 133 (13.5%) who underwent isolated revision had subsequent prosthesis failure [Hazard ratio (HR) 0.67, = .343]. The factor analysis of type of revision (full or isolated revision) did not demonstrate a significant difference between groups in terms of complications, implant failures, and times to failure. Metallosis was related to early time to failure [Hazard ratio 10.11, < .001] and iliotibial band release was associated with more complications (Odds ratio 9.87, = .027). Preoperative symptoms of instability were associated with the worst improvement in University of California Los Angeles score. Higher American Society of Anesthesiologists status and higher Charlson Comorbidity Index were related with worse VR-12 physical (−30.5, = .008) and knee osteoarthritis and outcome score for joint replacement (−4.2, = .050) scores, respectively. Isolated and full component revision TKA for aseptic loosening does not differ with respect to prosthesis failures, complications, and clinical results at 5 years. Poor American Society of Anesthesiologists status, increased comorbidities, instability, and a severe bone defect are related to worse functional improvement. III, cohort with control.

中文翻译：

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全膝关节置换术中无菌松动的孤立翻修与全组件翻修

对全膝关节置换术 (TKA) 的股骨和胫骨部件进行修复以防止无菌性松动，效果良好。仅修复一个松动部件，保留其他部件，手术时间更短，成本更低；然而，这些不同手术的种植体存活率和临床结果尚不清楚。 2009 年 1 月至 2019 年 12 月期间，对连续的 TKA 翻修队列进行了审查。使用单变量和多变量分析来研究因素与手术相关并发症、假体失效时间和功能结果之间的相关性（加州大学洛杉矶分校、膝关节协会功能性、膝骨关节炎和关节置换的结果评分、退伍军人 RAND 12 (VR- 12) 身体，VR-12 精神)。共有 238 名患者因无菌性松动接受了翻修 TKA。平均随访时间为 61 个月（范围 25 至 152 个月）。接受完全翻修（股骨和胫骨部件）的 105 名患者中有 10 名 (9.5%) 以及接受单独翻修的 133 名患者中有 18 名 (13.5%) 随后出现假体失败 [风险比 (HR) 0.67, = .343]。翻修类型（完全翻修或单独翻修）的因素分析并未显示各组之间在并发症、种植体失败和失败时间方面存在显着差异。金属化与早期失败相关[风险比10.11，< .001]，髂胫束松解与更多并发症相关（优势比9.87，= .027）。术前不稳定症状与加州大学洛杉矶分校评分的最差改善相关。较高的美国麻醉医师协会地位和较高的查尔森合并症指数分别与较差的 VR-12 身体评分 (−30.5, = .008) 和膝骨关节炎以及关节置换结果评分 (−4.2, = .050) 评分相关。针对无菌性松动的单独和全组件翻修 TKA 在假体失败、并发症和 5 年临床结果方面没有差异。美国麻醉医师协会的地位较差、合并症增加、不稳定和严重的骨缺损与功能改善较差有关。 III，对照组。