Single-institution retrospective study of 781 revision TKAs performed over 10 years at a high-volume arthroplasty center. Compares contemporary failure mechanisms against the same center's landmark 2002 cohort to track how TKA failure patterns have evolved. The central question: has the advent of improved implants and surgical technique changed why knees fail?
Frame every failed TKA workup around one question first: how long ago was the primary surgery? Infection dominates the first 2 years (37.6% of early revisions). Aseptic loosening takes over after that (51.4% of late revisions). These two failure modes together define the modern revision TKA landscape.
When you see a stiff knee attributed to arthrofibrosis, do not accept that diagnosis without ruling out chronic infection. The association between arthrofibrosis and occult PJI is real — a missed infection treated as scarring is a preventable disaster.
The near-disappearance of polyethylene wear (down to 3.5%) is a genuine success story for materials science. The unsolved problems are infection and loosening. Which is where research, prevention protocols, and surgical technique refinement need to focus.
Single-institution retrospective study of 781 revision TKAs performed over 10 years at a high-volume arthroplasty center. Compares contemporary failure mechanisms against the same center's landmark 2002 cohort to track how TKA failure patterns have evolved. The central question: has the advent of improved implants and surgical technique changed why knees fail?
Frame every failed TKA workup around one question first: how long ago was the primary surgery? Infection dominates the first 2 years (37.6% of early revisions). Aseptic loosening takes over after that (51.4% of late revisions). These two failure modes together define the modern revision TKA landscape.
When you see a stiff knee attributed to arthrofibrosis, do not accept that diagnosis without ruling out chronic infection. The association between arthrofibrosis and occult PJI is real — a missed infection treated as scarring is a preventable disaster.
The near-disappearance of polyethylene wear (down to 3.5%) is a genuine success story for materials science. The unsolved problems are infection and loosening. Which is where research, prevention protocols, and surgical technique refinement need to focus.