Why are Total Knee Arthroplasties Being Revised?

Despite technical improvements, revision rates for total knee arthroplasties (TKAs) remain high. Our goal was to report the reason(s) for revision TKA in a large, current, multicenter series and compare those reasons with previously published reasons. We retrospectively identified 820 consecutive revision TKAs (693 patients, 2000-2012) from our 3 centers and recorded the primary reason for the revision. The top seven reasons for the revision were aseptic loosening (23.1%), infection (18.4%), polyethylene wear (18.1%), instability (17.7%), pain/stiffness (9.3%), osteolysis (4.5%), and malposition/malalignment (2.9%). Comparison with previously published reasons showed fewer TKA revisions for polyethylene wear, osteolysis, instability, and malalignment. These changes may represent improvements in surgical technique and implants. (C) 2013 Elsevier Inc. All rights reserved.