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Early failures in total knee arthroplasty.

T K Fehring1, S Odum, W L Griffin

  • 1Charlotte Orthopedic Specialists Hip and Knee Center, and Charlotte Orthopedic Research Institute, NC, USA.

Clinical Orthopaedics and Related Research
|November 22, 2001
PubMed
Summary

Early total knee arthroplasty failure is often due to infection or instability. Cemented implants and careful balancing could significantly reduce early revision surgeries for knee replacements.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Clinical Research

Background:

  • Total knee arthroplasty (TKA) is generally successful.
  • A subset of patients requires revision surgery within five years due to TKA failure.

Purpose of the Study:

  • To analyze the primary reasons for early failure in TKAs requiring revision surgery within five years.

Main Methods:

  • Retrospective analysis of 440 patients undergoing revision surgery between 1986 and 1999.
  • Documented reasons for revision in TKAs that failed within five years of the index procedure.

Main Results:

  • Of 279 early failures, infection (38%) and instability (27%) were the most common causes.
  • Failure of cementless fixation (13%) and patellofemoral issues (8%) were also significant.

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  • Aseptic loosening of cemented implants was rare (3%).

    • Conclusions:

    • Infection and instability are major drivers of early TKA revision.
    • Improved implant fixation (cemented) and surgical technique (balancing) could reduce early revision rates by up to 40%.