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Observational Study
. 2018 Nov 10;19(1):395.
doi: 10.1186/s12891-018-2314-1.

Periprosthetic infection is the major indication for TKA revision - experiences from a university referral arthroplasty center

S P Boelch  1 , A Jakuscheit  1 , S Doerries  1 , L Fraissler  1 , M Hoberg  1 , J Arnholdt  2 , M Rudert  1
Affiliations
Observational Study

Periprosthetic infection is the major indication for TKA revision - experiences from a university referral arthroplasty center

S P Boelch et al. BMC Musculoskelet Disord. .

Abstract

Background: We hypothesized, that periprosthetic joint infection (PJI) accounts for the major proportion of first (primary) and repeated (secondary) Total Knee Arthroplasty revisions at our university referral arthroplasty center.

Methods: One thousand one hundred forty-three revisions, performed between 2008 and 2016 were grouped into primary (55%) and secondary (45%) revisions. The rate of revision indications was calculated and indications were categorized by time after index operation. The odds ratios of the indications for primary versus secondary revision were calculated.

Results: In the primary revision group PJI accounted for 22.3%, instability for 20.0%, aseptic loosening for 14.9% and retropatellar arthrosis for 14.2%. PJI (25.6%) was the most common indication up to 1 year after implantation, retropatellar arthrosis (26.8%) 1-3 years and aseptic loosening (25.6%) more than 3 years after implantation. In the secondary revision group PJI accounted for 39.7%, aseptic loosening for 16.2% and instability for 13.2%. PJI was the most common indication at any time of revision with 43.8% up to one, 35.4% 1-3 years and 39.4% more the 3 years after index operation. The odds ratios in repeated revision were 2.32 times higher (p = 0.000) for PJI. For instability and retropatellar arthrosis the odds ratios were 0.60 times (p = 0.006) and 0.22 times (p = 0.000) lower.

Conclusions: PJI is the most common indication for secondary TKA revision and within one year after primary TKA. Aseptical failures such as instability, retropatellar arthrosis and aseptical loosening are the predominant reasons for revision more than one year after primary TKA.

Keywords: Failure; Knee arthroplasty; Periprosthetic infection; Revision.

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Conflict of interest statement

Ethics approval and consent to participate

This observational study was performed at the Department of Orthopaedic Surgery, University of Wuerzburg, Wuerzburg, Germany. The approval for this study was waived by the University’s ethics committee “Ethik-Komission der Universität Würzburg” on the 20th of June 2018 (approval number 20180613 01). Consent to participate was waived along with this waiver.

Consent for publication

All authors gave consent on publishing the article.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Indications for primary revision
Fig. 2
Fig. 2
Distributions of indications for primary revision
Fig. 3
Fig. 3
Indications for secondary revision
Fig. 4
Fig. 4
Distributions of indications for secondary revision
See this image and copyright information in PMC

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