Symposium: Papers Presented at the Annual Meetings of the Knee Society

Clinical Orthopaedics and Related Research®

, Volume 468, Issue 1, pp 45-51

Open Access This content is freely available online to anyone, anywhere at any time.

The Epidemiology of Revision Total Knee Arthroplasty in the United States

  • Kevin J. BozicAffiliated withDepartment of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco Email author 
  • , Steven M. KurtzAffiliated withExponent, Inc.
  • , Edmund LauAffiliated withExponent, Inc.
  • , Kevin OngAffiliated withExponent, Inc.
  • , Vanessa ChiuAffiliated withDepartment of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
  • , Thomas P. VailAffiliated withDepartment of Orthopaedic Surgery, University of California, San Francisco
  • , Harry E. RubashAffiliated withDepartment of Orthopaedic Surgery, Massachusetts General Hospital
  • , Daniel J. BerryAffiliated withDepartment of Orthopaedic Surgery, Mayo Clinic

Abstract

Understanding the cause of failure and type of revision total knee arthroplasty (TKA) procedures performed in the United States is essential in guiding research, implant design, and clinical decision making in TKA. We assessed the causes of failure and specific types of revision TKA procedures performed in the United States using newly implemented ICD-9-CM diagnosis and procedure codes related to revision TKA data from the Nationwide Inpatient Sample (NIS) database. Clinical, demographic, and economic data were reviewed and analyzed from 60,355 revision TKA procedures performed in the United States between October 1, 2005 and December 31, 2006. The most common causes of revision TKA were infection (25.2%) and implant loosening (16.1%), and the most common type of revision TKA procedure reported was all component revision (35.2%). Revision TKA procedures were most commonly performed in large, urban, nonteaching hospitals in Medicare patients ages 65 to 74. The average length of hospital stay (LOS) for all revision TKA procedures was 5.1 days, and the average total charges were $49,360. However, average LOS, average charges, and procedure frequencies varied considerably by census region, hospital type, and procedure performed.

Level of Evidence: Level II, economic and decision analysis. See Guidelines for Authors for a complete description of levels of evidence.