Background and Purpose. Debate exists on whether septic revision total knee arthroplasty (TKA) results in inferior clinical\noutcomes, and limited information is available regarding the factors associatedwith such outcomes.This study aimed to (1) compare\nclinical outcomes and characteristics of aseptic versus septic revision TKA and (2) identify the risk factors associated with inferior\nclinical outcomes. Methods.We retrospectively reviewed 144 revision TKAs (90 aseptic and 54 septic revisions) that were followed\nfor a minimumof 3 years (mean = 7 years). Clinical outcome data, namely, Knee Society knee and function scores and the Hospital\nfor Special Surgery knee score, were collected. We reviewed 13 pre- and intraoperative variables. Results. Postoperative clinical\noutcomes were inferior in septic revision surgeries (p<0.05). In regression analyses, however, septic revisionwas not an independent\nrisk factor for poor clinical outcomes. The independent risk factors for poor outcome were identified where Anderson Orthopedic\nResearch Institute grade 3 femoral and tibial bone defects, more than three surgeries, and treatment for persistent infection were\nassociatedwith inferior clinical outcomes (all p<0.05). Standard two-stage septic revisionwithout grade 3 bone defects or additional\nsurgeries showed comparable outcomes to aseptic revision. Interpretation. Clinical outcomes of septic revision were inferior to those\nof aseptic revision. However, poor outcomes were mainly associated with large bone defects and an increased number of surgeries.\nThe outcomes of aseptic and septic revision surgery were similar when patients with larger bone defects and more than three\nsurgeries were excluded.
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