title: Why are total knees failing today? Etiology of total knee revision in 2010 and 2011.
abstract: Revision knee data from six joint arthroplasty centers were compiled for 2010 and 2011 to determine mechanism of failure and time to failure. Aseptic loosening was the predominant mechanism of failure (31.2%), followed by instability (18.7%), infection (16.2%), polyethylene wear (10.0%), arthrofibrosis (6.9%), and malalignment (6.6%). Mean time to failure was 5.9 years (range 10 days to 31 years). 35.3% of all revisions occurred less than 2 years after the index arthroplasty, 60.2% in the first 5 years. In contrast to previous reports, polyethylene wear is not a leading failure mechanism and rarely presents before 15 years. Implant performance is not a predominant factor of knee failure. Early failure mechanisms are primarily surgeon-dependent.
authors: St. Louis Joint Replacement Institute, SSM DePaul Health Center, St. Louis, Missouri.
authors: William C
authors: WC
authors: Schroer
authors: Keith R
authors: KR
authors: Berend
authors: Adolph V
authors: AV
authors: Lombardi
authors: C Lowry
authors: CL
authors: Barnes
authors: Michael P
authors: MP
authors: Bolognesi
authors: Michael E
authors: ME
authors: Berend
authors: Merrill A
authors: MA
authors: Ritter
authors: Ryan M
authors: RM
authors: Nunley
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D017760:Bone Malalignment / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000150:complications / Q000453:epidemiology; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D011475:Prosthesis Failure / Q000009:adverse effects / Q000209:etiology* / Q000639:trends*; D016459:Prosthesis-Related Infections / Q000150:complications / Q000453:epidemiology; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies
keywords: aseptic loosening; failure; instability; total knee revision