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Why knees fail in 2011: patient, surgeon, or device?
Steven J Fitzgerald1, Robert T Trousdale
1Department of Orthopedic Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
Orthopedics
|September 10, 2011
Summary
Total knee arthroplasty (TKA) success depends on patient selection, implant choice, and surgical skill. Understanding TKA failure factors is crucial to manage revision surgery burdens.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Patient Outcomes Research
Background:
- Total knee arthroplasty (TKA) is a highly successful procedure with patient satisfaction rates between 85-95%.
- Despite high success, TKA failure can have a significant negative impact on patients.
- The number of TKAs performed is projected to double, increasing the potential burden of revision surgeries.
Purpose of the Study:
- To discuss TKA failure rates.
- To identify patient, surgeon, and device-related factors contributing to TKA failure.
- To inform strategies for preventing complications and managing revision burdens.
Main Methods:
- Review of current literature on TKA outcomes and failure mechanisms.
- Analysis of factors influencing TKA success, including patient selection, implant design, and surgical technique.
- Discussion of preoperative optimization of medical comorbidities and psychosocial issues.
Main Results:
- While TKA is generally successful, recent data suggests a concerning number of early failures with modern techniques.
- Patient-reported outcomes are significantly influenced by medical comorbidities and psychosocial factors.
- Failure mechanisms are multifactorial, involving patient, surgeon, and device-related elements.
Conclusions:
- Understanding TKA failure mechanisms is critical for improving long-term outcomes.
- Preventing complications and optimizing patient factors are key to reducing the TKA revision burden.
- Comprehensive assessment of patient factors, alongside surgical and device considerations, is essential for successful TKA.
