International Orthopaedics

, Volume 35, Issue 8, pp 1157–1164 | Cite as

Failure following revision total knee arthroplasty: infection is the major cause

  • S. M. Javad Mortazavi
  • Jeremy Molligan
  • Matthew S. Austin
  • James J. Purtill
  • William J. Hozack
  • Javad ParviziEmail author
Original Paper


The objective of this study was to evaluate the survivorship of revision TKA and determine the reasons and predictors for failure. Between January 1999 to December 2005, 499 total knee arthroplasty revisions were performed on 474 patients. There were 292 (61.6%) women and 182 (38.4%) men. The average age at the time of index revision was 63.9 years. Revision was defined as surgery in which at least one component (tibial, patellar, femoral, or polyethylene) required exchange. At an average follow-up of 64.8 months (range, 24.1–111.6), and considering reoperation or re-revision as failure, there were 102 failures (18.3%). Infection was the major cause of failure (44.1%) followed by stiffness (22.6%), patellar or extensor mechanism problems (12.8%), periprosthetic fracture (5.9%), loosening (4.9%), haematoma formation (3.9%), malalignment (2.9%), and instability (2.9%). A total of 83% of failures were early (less than two years). Infection was the most common mechanism of failure of revision TKA. The majority of TKA revision failures tend to occur in the first two years after revision. The mode of failure of revision TKA appears to differ from the failure of primary TKA to some extent. Better understanding of current modes by which TKA revisions fail may enable surgeons to prevent these problems and improve outcomes for revision TKA.


Total Knee Arthroplasty Aseptic Loosening Periprosthetic Joint Infection Primary Total Knee Arthroplasty Revision Total Knee Arthroplasty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors do not have any conflicts of interest with regard to this research.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • S. M. Javad Mortazavi
    • 1
  • Jeremy Molligan
    • 1
  • Matthew S. Austin
    • 1
  • James J. Purtill
    • 1
  • William J. Hozack
    • 1
  • Javad Parvizi
    • 1
    Email author
  1. 1.Rothman Institute of OrthopedicsThomas Jefferson University HospitalPhiladelphiaUSA

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