Abstract
Introduction. Total knee arthroplasty (TKA) is a recognized highly effective method for treating gonarthrosis. However, outcomes of aseptic revisions remain less predictable, with a significant proportion of dissatisfied patients amid the growing number of such interventions.
Aim of the study. To summarize contemporary data on clinical outcomes, quality of life, and patient satisfaction following aseptic revision knee arthroplasty (RKA), as well as to analyze predictors of unfavorable results reported in the literature for this patient population.
Materials and methods. A search of publications from 2010–2026 was conducted in PubMed/MEDLINE, Scopus, Google Scholar, eLibrary.ru, and CyberLeninka databases. The review included studies with follow-up ≥12 months containing data on clinical outcomes, patient satisfaction, and/or predictors of unfavorable outcomes after aseptic RKA. The final review incorporated 74 studies published between 1987–2026, 93% of which were from the last 10 years.
Results and discussion. Clinical outcomes, quality of life, and patient satisfaction after aseptic RKA are substantially lower than after primary TKA. Intervention outcomes are influenced by age, sex, body mass index, comorbidity, reason for revision, number of prior knee interventions, technical aspects of revision surgery, preoperative range of motion, ligamentous apparatus condition, and the interval between primary TKA and revision surgery. Validated prognostic models for RKA are virtually absent, with most studies limited to analysis of individual predictors.
Conclusion. Aseptic RKA remains a technically challenging procedure with less predictable outcomes and a significant proportion of dissatisfied patients compared to primary total TKA. With the growing number of revision knee arthroplasties, the clinical and economic significance of these operations increases. Priority should be given to developing and validating a multifactorial prognostic model, as well as implementing personalized patient selection and management strategies to set realistic preoperative expectations, improve satisfaction with revision surgery results, and achieve more rational use of healthcare resources.