Assessment of Failure Modes in Total Knee Replacement Arthroplasty

ABSTRACT

PURPOSE: To analyze the causes of revision total knee arthroplasty and evaluate the difference in failure modes according to the revision interval after a primary total knee arthroplasty. MATERIALS AND METHODS: We retrospectively analyzed the failure mode of 60 cases assessable by clinical, radiological and operative findings according to the following intervals after primary total knee arthroplasty under 5 years; from 5 to 10 years; and after 10 years. RESULTS: In 50% of the cases osteolysis and loosening was the cause for revision total knee arthroplasty. In comparison, tibial polyethylene insert wear occurred in 25% of the cases, infection in 13%, instability in 7%, and stiffness in 5%. The average duration from primary total knee arthroplasty to revision arthroplasty due to infection, stiffness and instability was less than 5 years. In contrast, revision arthroplasty resulting from tibial polyethylene wear, osteolysis and loosening took place after 5 years. CONCLUSION: The most common failure mode is osteolysis and loosening regardless of the revision interval. Infection and instability was common in the under-5-year period and osteolysis and loosening was common after 5 years.