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. 2021 Aug;141(8):1373-1383.
doi: 10.1007/s00402-020-03698-8. Epub 2021 Jan 30.

Infection and periprosthetic fracture are the leading causes of failure after aseptic revision total knee arthroplasty

Juliette A Meyer  1 , Mark Zhu  1 , Alana Cavadino  1 , Brendan Coleman  2 , Jacob T Munro  3 , Simon W Young  4   5
Affiliations

Infection and periprosthetic fracture are the leading causes of failure after aseptic revision total knee arthroplasty

Juliette A Meyer et al. Arch Orthop Trauma Surg. 2021 Aug.

Abstract

Aim: The purpose of this study was to clarify the medium to long term survival of aseptic revision total knee arthroplasty (RTKAs) and identify the common modes of failure following RTKAs.

Materials and methods: A multi-center, retrospective study included all aseptic RTKAs performed at three tertiary referral hospitals between 2003 and 2016. Patients were excluded if the revision was for prosthetic joint infection (PJI) or they had previously undergone revision surgery. Minor revisions not involving the tibial or femoral components were also excluded. Demographics, surgical data and post-operative outcomes were recorded and analyzed. Survival analysis was performed and the reasons for revision failure identified.

Results: Of 235 aseptic RTKAs identified, 14.8% underwent re-revision at mean follow-up of 8.3 years. Survivorship of RTKA was 93% at 2 years and 83% at 8 years. Average age at revision was 72.9 years (range 53-91.5). The most common reasons for failure following RTKA were periprosthetic joint infection (PJI) (40%), periprosthetic fracture (25.7%) and aseptic loosening (14.3%). Of those whose RTKA failed, the average survival was 3.33 years (8 days-11.4 years). No demographic or surgical factors were found to influence RTKA survival on univariate or multivariate analysis.

Conclusion: PJI and periprosthetic fracture are the leading causes of re-revision surgery following aseptic revision TKA. Efforts to improve outcomes of aseptic revision TKA should focus on these areas, particularly prevention of PJI.

Keywords: Periprosthetic fracture; Periprosthetic joint infection; Revision total knee arthroplasty.

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References

    1. Labek G, Thaler M, Janda W, Agreiter M, Stockl B (2011) Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg Br 93:293–297 - PubMed - DOI
    1. Abdel MP, Morrey ME, Jensen MR et al (2011) Increased long-term survival of posterior cruciate-retaining versus posterior cruciate-stabilizing total knee replacements. J Bone Joint Surg Am 93:2072–2078 - PubMed - DOI
    1. Cram P, Lu X, Kates SL et al (2012) Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991–2010. JAMA 308:1227–1236 - PubMed - PMC - DOI
    1. Bayliss LE, Culliford D, Monk AP et al (2017) The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet 389:142–230 - DOI
    1. Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 467:2606–2612 - PubMed - PMC - DOI

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