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Related Concept Videos

Knee Joint01:23

Knee Joint

3.8K
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...
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Related Experiment Video

Updated: Apr 21, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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The problem total knee replacement: systematic, comprehensive and efficient evaluation.

K G Vince1

  • 1Northland District Health Board, Department of Orthopaedic Surgery, Whangarei, New Zealand.

The Bone & Joint Journal
|November 9, 2014
PubMed
Summary
This summary is machine-generated.

Total knee replacement (TKR) revision success hinges on accurately assessing failure causes. A systematic approach to identifying specific failure modes, like sepsis or loosening, is crucial for effective surgical solutions.

Keywords:
Knee arthroplastydiagnosisfailedinvestigationmodes of failurerevision

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Clinical diagnostics

Background:

  • Total knee replacement (TKR) failure necessitates revision surgery.
  • Current understanding often lacks systematic assessment of TKR failure modes.
  • Consensus on definitions and classification of TKR failure is limited.

Purpose of the Study:

  • To establish a systematic framework for assessing total knee replacement failures.
  • To define distinct modes of TKR failure requiring specific surgical interventions.
  • To emphasize the importance of problem assessment in revision TKR success.

Main Methods:

  • Review and categorization of common total knee replacement failure modes.
  • Description of eight specific failure categories requiring tailored surgical solutions.
  • Distinction between surgical indications and conditions requiring further investigation (e.g., unexplained pain).

Main Results:

  • Identified eight distinct modes of total knee replacement failure: sepsis, extensor discontinuity, stiffness, tibiofemoral instability, patellar tracking issues, aseptic loosening/osteolysis, periprosthetic fracture, and component breakage.
  • Highlighted the need for a systematic, comprehensive, and efficient approach to TKR problem assessment.
  • Differentiated unexplained pain as a symptom requiring investigation, not immediate surgery.

Conclusions:

  • Successful total knee replacement revision surgery is critically dependent on accurate assessment of the underlying failure mode.
  • A structured approach to identifying specific TKR failure mechanisms is essential for guiding appropriate surgical strategies.
  • Standardized definitions and systematic evaluation are needed to improve outcomes in revision knee replacement surgery.