Are the relative indications for revision total knee arthroplasty changing?

There are relatively few data on the indications for revision total knee arthroplasty. The purpose of this study was to determine if the indications for revision have changed over the past decade. This is a retrospective review of demographic data and the indications for revision in two cohorts of patients by one surgeon. Patient gender, age, weight, time in situ, and reason for revision (eight categories) were recorded and analyzed by unpaired t-tests and chi-square tests. The first cohort was 81 revisions performed between 1990 and 1999. The second cohort was 116 revisions performed between 2000 and April 2008. There were no significant differences in the gender, mean age, mean weight, or mean time in situ between the two cohorts. There were more revisions for wear (p = .03) and instability (p = .06) in the recent cohort. There were significantly fewer revisions related to the patella prosthesis (p < .0001). There was no change in the number of revisions for infection between the two cohorts. The relative indications for revision total knee arthroplasty have changed over the past decade. Greater emphasis may be needed on improved balancing techniques to prevent instability and new bearing surfaces to decrease wear.