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Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

A dramatic increase in the demand for TKA is expected. The current burden of revision TKA is well known but the incidence and etiology of nonrevision reoperations after primary TKA is not.

Questions/purposes

We determined the rate, reason, timing, and predictors of nonrevision reoperation after TKA.

Methods

Using our institutional joint arthroplasty database, we identified 10,188 TKA performed on 7,613 patients between April 2000 and March 2008. A nonrevision reoperation was defined as any procedure requiring anesthetic in which components with bony interfaces were not removed or exchanged. Procedures after revision TKA were excluded. Potential risk factors investigated included age, gender, laterality, and simultaneous bilateral versus staged bilateral versus unilateral TKA. The minimum followup was 1 year (median, 4.1 years; range, 1.1 to 9.1 years).

Results

Three hundred fifty-three patients of 7,613 (4.6%) underwent 434 nonrevision reoperations on 384 of 10,188 (3.8%) knees. The most common indication for nonrevision reoperation was stiffness (58%; 252 of 434), followed by patellar clunk (12%; 53), infection (12%; 52), wound revision (6%; 26), hematoma (4.4%; 19), among others. The median time to reoperation was 74.5 days (range, 1–3058 days) but varied widely. Younger patients and those with unilateral TKA were more likely to have a nonrevision reoperation.

Conclusions

The majority of nonrevision reoperations are performed for stiffness. Patellar clunk and infection also result in a large number of nonrevision reoperations. In weighing the future economic and workforce burden of TKA, nonrevision reoperations need to be acknowledged, and preventive measures need to be implemented.

Level of Evidence

Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA

    Benjamin Zmistowski BS, Camilo Restrepo MD, Lauren K. Kahl BS, Javad Parvizi MD, FRCS & Peter F. Sharkey MD

Authors
  1. Benjamin Zmistowski BS
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  2. Camilo Restrepo MD
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  3. Lauren K. Kahl BS
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  4. Javad Parvizi MD, FRCS
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  5. Peter F. Sharkey MD
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Corresponding author

Correspondence to Peter F. Sharkey MD.

Additional information

Javad Parvizi is a consultant for Stryker Orthopaedics (Mahwah, NJ) and has intellectual properties on SmarTech (Philadelphia, PA); Peter F. Sharkey is a consultant for Stryker Orthopaedics.

Each author certifies that his/her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Zmistowski, B., Restrepo, C., Kahl, L.K. et al. Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty. Clin Orthop Relat Res 469, 138–145 (2011). https://doi.org/10.1007/s11999-010-1558-3

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  • DOI: https://doi.org/10.1007/s11999-010-1558-3

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