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Updated: May 9, 2026

The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

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Why are total knee arthroplasties being revised?

David F Dalury¹, Donald L Pomeroy, Robert S Gorab

¹Towson Orthopaedic Associates, Towson, Maryland.

The Journal of Arthroplasty

|July 27, 2013

Summary

Revision rates for total knee arthroplasty (TKA) remain high. Aseptic loosening, infection, and wear are leading causes, though some reasons like wear and instability have decreased, suggesting implant and technique improvements.

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Knee Joint

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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris group...

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Area of Science:

Orthopedic Surgery
Biomaterials Science

Background:

Revision rates for total knee arthroplasty (TKA) remain a significant concern in orthopedic surgery.
Despite advancements, understanding current reasons for TKA revision is crucial for improving patient outcomes.

Purpose of the Study:

To identify and analyze the primary reasons for revision TKA in a large, contemporary, multicenter patient cohort.
To compare these contemporary revision reasons with historical data to identify trends and potential improvements.

Main Methods:

Retrospective analysis of 820 consecutive revision TKAs performed between 2000 and 2012 across three medical centers.
Primary reason for each revision was documented and categorized.

Main Results:

Keywords:

current diagnosis knee arthroplasty outcome;revision total knee arthroplasty

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The most frequent reasons for TKA revision were aseptic loosening (23.1%), infection (18.4%), polyethylene wear (18.1%), and instability (17.7%).

Pain/stiffness, osteolysis, and malposition/malalignment accounted for the remaining revisions.

A notable decrease in TKA revisions attributed to polyethylene wear, osteolysis, instability, and malalignment was observed compared to previous studies.

Conclusions:

Aseptic loosening and infection remain the predominant indications for TKA revision.
Observed reductions in revisions for wear, osteolysis, instability, and malalignment suggest progress in implant design and surgical techniques for total knee arthroplasty.