This article is more than 5 years old. Information may no longer be current.
Data show reductions in implant-associated revisions after TKA
Click Here to Manage Email Alerts
The primary failure mechanisms leading to revision surgery after total knee arthroplasty continue to be aseptic loosening, instability, malalignment and periprosthetic infection, according to researchers’ findings; however, compared with previous studies, a substantial reduction in implant revisions, such as those resulting from polyethylene wear, was observed.
The researchers retrospectively assessed 358 total knee arthroplasty revisions from 2005 to 2010. Revisions were characterized as the replacement of one or more prosthetic parts, and failure time intervals were defined as early, intermediate or late failures (<1 year, 1 to 3 years, or > 3 years, respectively). The failure mechanism categories included in the study were polyethylene wear, aseptic loosening, instability, periprosthetic infection or fracture, arthrofibrosis, malalignment, extensor mechanism insufficiency and progressive retropatellar arthritis.
Polyethylene wear was diagnosed with macroscopic and microscopic findings. The researchers also evaluated malpositioning and malrotation with radiographs and CT scans.
Results showed the failure rate was highest within the first 6 years after the initial surgery. Out of all patients, 19.9% needed revision within 1 year of the initial surgery. For 45.5% of patients, a second surgery was needed between 1 and 3 years, and 34.6% needed additional surgery after more than 3 years.
According to the researchers, the most common reasons for revision aside from aseptic loosening were instability, malalignment and periprosthetic infection. Polyethylene wear revisions rarely occurred, observed in only 7% of patients.
In the earlier failure group, primary revision causes were periprosthetic infection and instability. The intermediate group’s revision causes were instability and malalignment, whereas in the late-failure group, revision was needed after aseptic loosening, instability and polyethylene wear, according to the researchers. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial support.
Collapse
Click Here to Manage Email Alerts