Why are Total Knee Arthroplasties Being Revised?
Section snippets
Materials and Methods
After receiving institutional review board approval, we retrospectively reviewed our patient databases at 3 separate centers and identified 820 consecutive knees (693 patients) that had undergone a RTKA from 2000 through 2011. We defined revision as a reoperation for any reason. We did not include any reoperations on unicondylar knee replacements in our series. The 410 women and 283 men had a mean age of 69 years (range, 24–94 years), a mean body mass index of 31 kg/m2 (range, 18–60 kg/m2), and a
Results
Overall, the 6 most frequent reasons for revision were aseptic loosening (23.1%), infection (18.4%), polyethylene wear (18.1%), instability (17.7%), pain/stiffness (9.3%), osteolysis (4.5%), and malposition (2.9%) (Table 8., 9.). We considered instability and malposition to be predominantly influenced by the surgeon; these 2 reasons represented 21% of all revisions.
When the causes of revision were subdivided by time into “early” (less than 5 years [60 months]) and “late” (equal to or more than 5
Discussion
Although there is general agreement on the success of primary TKA, RTKA does not compare as well. The costs of RTKA are high and the results, compared with primary TKA, are inferior [10]. Ong et al [11] showed that a RTKA has a 5 to 6 times increased risk of re-revision. In a recent study, Baker et al [12] showed that improvement after a RTKA was only 69%–76% of a primary TKA and that the Medicare database showed the 5-year survivorship of RTKA to be only 87%.
Our series shows that, compared
References (12)
- et al.
Functional outcome after total knee arthroplasty revision: a meta-analysis
J Arthroplasty
(2002) - et al.
Survivorship of cemented total knee arthroplasty
Clin Orthop Relat Res
(1997) - et al.
Long-term survival analysis of a posterior cruciate-retaining total condylar total knee arthroplasty
Clin Orthop Relat Res
(1994) - et al.
The Chitranjan Ranawat Award: long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties
Clin Orthop Relat Res
(2006) - et al.
Kinematic condylar total knee arthroplasty. 14-year survivorship analysis of 208 consecutive cases
J Bone Joint Surg Br
(1996) - et al.
Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002
J Bone Joint Surg Am
(2005)
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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.04.051.