Retrospective review of 212 consecutive revision TKAs at a single institution (1997–2000). The study asks not just how often TKAs fail, but specifically why and when each failure mode occurs. It is the canonical reference for the taxonomy of TKA failure by mode and timing.
Half of TKA revisions happen within 2 years of the index operation, and half of those early failures are directly traceable to what the surgeon did — or did not do. At the time of implantation.
When you are placing a primary TKA, the decisions that most protect your patient are: cemented fixation with cement around the tibial keel (not surface-only), meticulous ligament balancing to prevent instability, and precise component alignment. These are not subtle refinements. They are the leading reasons knees come back to the OR.
Infection management also starts at the index case. The 30-of-37 perioperative infection finding means wound surveillance and early aggressive intervention (irrigation and debridement) are as important as OR technique.
For late failures, polyethylene wear is the target. This paper is part of the evidence base that drove the shift toward highly cross-linked polyethylene and improved bearing surface design in the 2000s.
Retrospective review of 212 consecutive revision TKAs at a single institution (1997–2000). The study asks not just how often TKAs fail, but specifically why and when each failure mode occurs. It is the canonical reference for the taxonomy of TKA failure by mode and timing.
Half of TKA revisions happen within 2 years of the index operation, and half of those early failures are directly traceable to what the surgeon did — or did not do. At the time of implantation.
When you are placing a primary TKA, the decisions that most protect your patient are: cemented fixation with cement around the tibial keel (not surface-only), meticulous ligament balancing to prevent instability, and precise component alignment. These are not subtle refinements. They are the leading reasons knees come back to the OR.
Infection management also starts at the index case. The 30-of-37 perioperative infection finding means wound surveillance and early aggressive intervention (irrigation and debridement) are as important as OR technique.
For late failures, polyethylene wear is the target. This paper is part of the evidence base that drove the shift toward highly cross-linked polyethylene and improved bearing surface design in the 2000s.