Revision total knee arthroplasty

Abstract

Diagnosis of the failed total knee arthroplasty (TKA) should proceed in a systematic manner, with insight into the most common etiologies of failure. Other than infection, flexion instability has emerged as the most common reason for early revision TKA. Methods for reconstruction of bone loss include cement and screws and block augments for moderate defects, and large defects are managed with metaphyseal porous metal cones or partially porous modular stepped sleeves. Adequate short-term clinical results have been obtained with both methods. Registry data document a 22% reoperation rate at 10 years after revision TKA. Clinical outcomes of revision TKA in young patients and those undergoing revision for infection are associated with an increased risk of poor outcome. Patient satisfaction is also reportedly lower with revision TKA than with primary TKA, and is even lower for those undergoing revision for infection.