Revision surgery for failed total knee arthroplasty (TKA) continues to pose a substantial burden for patients, providers, and the United States healthcare system. Historically, leading causes for revision have included infection, osteolysis, loosening, stiffness, and instability. However, the predominant etiology of TKA failure has changed over time and may vary between reports based on many factors including study design, patient demographics and other regional factors. In order to effectively acknowledge modes of implant failure and maximize postoperative outcomes, it is essential to understand the present epidemiology of revision TKAs. This study aims to update the current literature on this topic by using a large national database. Specifically, we analyzed: 1) etiologies for revision TKA; 2) frequencies of revision TKA procedures; 3) various demographics including payer type and region; and 4) the length of stay (LOS) and total charges based on type of revision TKA procedure.
Infection and mechanical loosening are the leading indications for revision total knee arthroplasty in the United States. Additionally our analysis demonstrated higher rates of TKA revision in the South census region. Patients who underwent arthrotomy for removal of prosthesis without replacement procedures had the longest lengths of stay, and femoral component revisions incurred the highest charges. With the projected increase in primary TKAs performed annually, it is essential for orthopaedists to understand the factors contributing to implant failure and revision. Continued insight into the etiology and epidemiology of revision TKA procedures may be the principle step towards improving outcomes and mitigating the need for future revisions.
Copyright remains with the authors and publisher.
Revision surgery for failed total knee arthroplasty (TKA) continues to pose a substantial burden for patients, providers, and the United States healthcare system. Historically, leading causes for revision have included infection, osteolysis, loosening, stiffness, and instability. However, the predominant etiology of TKA failure has changed over time and may vary between reports based on many factors including study design, patient demographics and other regional factors. In order to effectively acknowledge modes of implant failure and maximize postoperative outcomes, it is essential to understand the present epidemiology of revision TKAs. This study aims to update the current literature on this topic by using a large national database. Specifically, we analyzed: 1) etiologies for revision TKA; 2) frequencies of revision TKA procedures; 3) various demographics including payer type and region; and 4) the length of stay (LOS) and total charges based on type of revision TKA procedure.
Infection and mechanical loosening are the leading indications for revision total knee arthroplasty in the United States. Additionally our analysis demonstrated higher rates of TKA revision in the South census region. Patients who underwent arthrotomy for removal of prosthesis without replacement procedures had the longest lengths of stay, and femoral component revisions incurred the highest charges. With the projected increase in primary TKAs performed annually, it is essential for orthopaedists to understand the factors contributing to implant failure and revision. Continued insight into the etiology and epidemiology of revision TKA procedures may be the principle step towards improving outcomes and mitigating the need for future revisions.
Copyright remains with the authors and publisher.