Advanced Biomedical Research

Causes and rates of revision total knee arthroplasty: Local results from Isfahan, Iran

Authors

1 Department of Orthopedy, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Knee replacement is one of the most frequently performed surgical procedures in the world. Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the rates and causes of revision TKA in Kashani Hospital (Isfahan, Iran) from 2011 to 2013.
Materials and Methods: We assessed all primary TKA and revision TKA procedures performed from 2011 to 2013 for the rate and causes of failures. Demographic data, duration from primary TKA to revision TKA and underlying diagnosis for primary TKA were also assessed.
Results: Overall, 353 primary TKA procedures carried out in this period. The overall revisions following primary TKA in this period was 24 cases, indicating a revision burden of 6.8%. The most common cause of revision TKA was infection, which was in 16 cases (44.4%). Other causes included patellar complications, mechanical loosening of both tibia and femur, mechanical loosening of tibia, instability, and periprosthetic fracture. The main revision procedures were all component revision, tibial component revision, isolated tibial insert exchange and patellar tendon repair. The most common revision procedure was two stage all component revision, which was carried out in 13 subjects (36.1%).
Conclusion: Local indications for revision TKA are mainly similar to those in other large centers. As compared with other centers, with considering the follow-up time, revision burden is relatively higher in this center.

Keywords

1.
Waller C, Hayes D, Block JE, London NJ. Unload it: The key to the treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011;19:1823-9.  Back to cited text no. 1
    
2.
Palomo JM. Surgical options for middle-aged patients with osteoarthritis of the knee. J Bone Joint Surg Am 2001;83-A: 1429.  Back to cited text no. 2
    
3.
Bhandari M, Smith J, Miller LE, Block JE. Clinical and economic burden of revision knee arthroplasty. Clin Med Insights Arthritis Musculoskelet Disord 2012;5:89-94.  Back to cited text no. 3
    
4.
Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: National projections from 2010 to 2030. Clin Orthop Relat Res 2009;467:2606-12.  Back to cited text no. 4
    
5.
Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 2005;87:1487-97.  Back to cited text no. 5
    
6.
Tai CC, Cross MJ. Five- to 12-year follow-up of a hydroxyapatite-coated, cementless total knee replacement in young, active patients. J Bone Joint Surg Br 2006;88:1158-63.  Back to cited text no. 6
    
7.
Murphy M, Journeaux S, Russell T. High-flexion total knee arthroplasty: A systematic review. Int Orthop 2009;33:887-93.  Back to cited text no. 7
    
8.
Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007;89:780-5.  Back to cited text no. 8
    
9.
Hossain F, Patel S, Haddad FS. Midterm assessment of causes and results of revision total knee arthroplasty. Clin Orthop Relat Res 2010;468:1221-8.  Back to cited text no. 9
    
10.
Kreder HJ, Grosso P, Williams JI, Jaglal S, Axcell T, Wal EK, et al. Provider volume and other predictors of outcome after total knee arthroplasty: A population study in Ontario. Can J Surg 2003;46:15-22.  Back to cited text no. 10
    
11.
Kurtz SM, Ong KL, Lau E, Widmer M, Maravic M, Gómez-Barrena E, et al. International survey of primary and revision total knee replacement. Int Orthop 2011;35:1783-9.  Back to cited text no. 11
    
12.
Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 2002;404:7-13.  Back to cited text no. 12
    
13.
Mortazavi SM, Molligan J, Austin MS, Purtill JJ, Hozack WJ, Parvizi J. Failure following revision total knee arthroplasty: Infection is the major cause. Int Orthop 2011;35:1157-64.  Back to cited text no. 13
    
14.
Paxton EW, Furnes O, Namba RS, Inacio MC, Fenstad AM, Havelin LI. Comparison of the Norwegian knee arthroplasty register and a United States arthroplasty registry. J Bone Joint Surg Am 2011;93 Suppl 3:20-30.  Back to cited text no. 14
    
15.
Ong KL, Lau E, Suggs J, Kurtz SM, Manley MT. Risk of subsequent revision after primary and revision total joint arthroplasty. Clin Orthop Relat Res 2010;468:3070-6.  Back to cited text no. 15
    
16.
Serra-Sutton V, Allepuz A, Espallargues M, Labek G, Pons JM. Arthroplasty registers: a review of international experiences. Int J Technol Assess Health Care 2009;25:63-72.  Back to cited text no. 16
    
17.
Saleh KJ, Rand JA, McQueen DA. Current status of revision total knee arthroplasty: How do we assess results? J Bone Joint Surg Am 2003;85-A Suppl 1:S18-20.  Back to cited text no. 17
    
18.
Labek G, Thaler M, Janda W, Agreiter M, Stöckl B. Revision rates after total joint replacement: Cumulative results from worldwide joint register datasets. J Bone Joint Surg Br 2011;93:293-7.  Back to cited text no. 18
    
19.
Pabinger C, Berghold A, Boehler N, Labek G. Revision rates after knee replacement. Cumulative results from worldwide clinical studies versus joint registers. Osteoarthritis Cartilage 2013;21:263-8.  Back to cited text no. 19
    
20.
Frank RM, Cross MB, Della Valle CJ. Periprosthetic joint infection: Modern aspects of prevention, diagnosis, and treatment. J Knee Surg 2014. [Epub ahead of print]  Back to cited text no. 20
    
21.
Rodriguez-Merchan EC. Instability following total knee arthroplasty. HSS J 2011;7:273-8.  Back to cited text no. 21
    
22.
Gonzalez MH, Mekhail AO. The failed total knee arthroplasty: Evaluation and etiology. J Am Acad Orthop Surg 2004;12:436-46.  Back to cited text no. 22
    
23.
Paley D. Principles of Deformity Correction. 3 rd ed. New York: spriger-Verlag Berlin Heidelberg; 2005. p. 19-30.  Back to cited text no. 23
    
24.
Julin J, Jämsen E, Puolakka T, Konttinen YT, Moilanen T. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register. Acta Orthop 2010;81:413-9.  Back to cited text no. 24
    
25.
Kasahara Y, Majima T, Kimura S, Nishiike O, Uchida J. What are the causes of revision total knee arthroplasty in Japan? Clin Orthop Relat Res 2013;471:1533-8.  Back to cited text no. 25
    
26.
Sibanda N, Copley LP, Lewsey JD, Borroff M, Gregg P, MacGregor AJ, et al. Revision rates after primary hip and knee replacement in England between 2003 and 2006. PLoS Med 2008;5:e179.  Back to cited text no. 26
    
27.
Tay KS, Lo NN, Yeo SJ, Chia SL, Tay DK, Chin PL. Revision total knee arthroplasty: Causes and outcomes. Ann Acad Med Singapore 2013;42:178-83.  Back to cited text no. 27
    
28.
Mikulak SA, Mahoney OM, dela Rosa MA, Schmalzried TP. Loosening and osteolysis with the press-fit condylar posterior-cruciate-substituting total knee replacement. J Bone Joint Surg Am 2001;83-A: 398-403.  Back to cited text no. 28
    
29.
Bozic KJ, Kurtz SM, Lau E, Ong K, Chiu V, Vail TP, et al. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res 2010;468:45-51.  Back to cited text no. 29
    
30.
Maradit Kremers H, Visscher SL, Moriarty JP, Reinalda MS, Kremers WK, Naessens JM, et al. Determinants of direct medical costs in primary and revision total knee arthroplasty. Clin Orthop Relat Res 2013;471:206-14.  Back to cited text no. 30
Advanced Biomedical Research
Volume 2015, May
May 2015
Pages 1-5