Clinical Orthopaedics and Related Research®

, Volume 471, Issue 5, pp 1533–1538 | Cite as

What Are the Causes of Revision Total Knee Arthroplasty in Japan?

  • Yasuhiko Kasahara
  • Tokifumi Majima
  • Shoichi Kimura
  • Osamu Nishiike
  • Jun Uchida
Symposium: Special Considerations for TKA in Asian Patients

Abstract

Background

There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries.

Questions/purposes

We therefore determined (1) causes of revision TKA in a cohort of Japanese patients with revision TKA and (2) whether patient demographic features and underlying diagnosis of primary TKA are associated with the causes of revision TKA.

Methods

We assessed all revision TKA procedures performed at five major centers in Hokkaido from 2006 to 2011 for the causes of failures. Demographic data and underlying diagnosis for index primary TKA of the revision cases were compared to those of randomly selected primary TKAs during the same period.

Results

One hundred forty revision TKAs and 4047 primary TKAs were performed at the five centers, indicating a revision burden of 3.3%. The most common cause of revision TKA was mechanical loosening (40%) followed by infection (24%), wear/osteolysis (9%), instability (9%), implant failure (6%), periprosthetic fracture (4%), and other reasons (8%). The mean age of patients with periprosthetic fracture was older (77 versus 72 years) and the male proportion in patients with infection was higher (33% versus 19%) than those of patients in the primary TKA group. There was no difference in BMI between primary TKAs and any type of revision TKA except other causes.

Conclusions

The revision burden at the five referral centers in Hokkaido was 3.3%, and the most common cause of revision TKA was mechanical loosening followed by infection. Demographic data such as age and sex might be associated with particular causes of revision TKA.

Notes

Acknowledgments

The authors thank Noriaki Mori MD, PhD (Department of Orthopaedic Surgery, Eniwa Hospital), Jun Nishiike MD (Department of Orthopaedic Surgery, Kushiro-Sanjikai Hospital), Reo Goto MD (Department of Orthopaedic Surgery, Abashiri Kousei Hospital), and Ryo Ando MD (Department of Orthopaedic Surgery, Hakodate Central General Hospital) for collecting cohort data at their hospitals. We also thank Koji Oba PhD for his help in the statistics in this study.

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Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Yasuhiko Kasahara
    • 1
  • Tokifumi Majima
    • 2
  • Shoichi Kimura
    • 3
  • Osamu Nishiike
    • 4
    • 5
  • Jun Uchida
    • 6
  1. 1.Department of Orthopaedic SurgeryHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Department of Joint Replacement and Tissue EngineeringHokkaido University Graduate School of MedicineSapporoJapan
  3. 3.Department of Orthopaedic SurgeryEniwa HospitalEniwaJapan
  4. 4.Department of Orthopaedic SurgeryKushiro-Sanjikai HospitalKushiroJapan
  5. 5.Department of Orthopaedic SurgeryAbashiri Kousei HospitalAbashiriJapan
  6. 6.Department of Orthopaedic SurgeryHakodate Central General HospitalHakodateJapan

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