Failure following revision total knee arthroplasty: infection is the major cause
- 21 October 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Orthopaedics
- Vol. 35 (8), 1157-1164
- https://doi.org/10.1007/s00264-010-1134-1
Abstract
The objective of this study was to evaluate the survivorship of revision TKA and determine the reasons and predictors for failure. Between January 1999 to December 2005, 499 total knee arthroplasty revisions were performed on 474 patients. There were 292 (61.6%) women and 182 (38.4%) men. The average age at the time of index revision was 63.9 years. Revision was defined as surgery in which at least one component (tibial, patellar, femoral, or polyethylene) required exchange. At an average follow-up of 64.8 months (range, 24.1–111.6), and considering reoperation or re-revision as failure, there were 102 failures (18.3%). Infection was the major cause of failure (44.1%) followed by stiffness (22.6%), patellar or extensor mechanism problems (12.8%), periprosthetic fracture (5.9%), loosening (4.9%), haematoma formation (3.9%), malalignment (2.9%), and instability (2.9%). A total of 83% of failures were early (less than two years). Infection was the most common mechanism of failure of revision TKA. The majority of TKA revision failures tend to occur in the first two years after revision. The mode of failure of revision TKA appears to differ from the failure of primary TKA to some extent. Better understanding of current modes by which TKA revisions fail may enable surgeons to prevent these problems and improve outcomes for revision TKA.Keywords
This publication has 58 references indexed in Scilit:
- Prophylactic oral antibiotics reduce reinfection rates following two-stage revision total knee arthroplastyInternational Orthopaedics, 2010
- Comparison of static and mobile antibiotic-impregnated cement spacers for the treatment of infected total knee arthroplastyInternational Orthopaedics, 2009
- The microbiology of the infected knee arthroplastyInternational Orthopaedics, 2009
- Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030The Journal of Bone & Joint Surgery, 2007
- Why Are Total Knee Arthroplasties Failing Today?Clinical Orthopaedics and Related Research, 2002
- 2-Stage Reimplantation for Infected Total Knee ReplacementClinical Orthopaedics and Related Research, 1996
- Periprosthetic Knee SepsisClinical Orthopaedics and Related Research, 1991
- Results of Revision Total Knee Arthroplasty Performed for Aseptic LooseningPublished by Ovid Technologies (Wolters Kluwer Health) ,1990
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987
- Management of Infected Total Knee ArthroplastyClinical Orthopaedics and Related Research, 1986