TKR Revisions Rise

It is not news that the number of total knee replacement surgeries are continuing to rise but it is discouraging (and perhaps understandable) that the number of revision total knee replacement (TKR) surgeries are going up as well. Using the Nationwide Inpatient Sample (NIS), researchers looked at the cause of knee replacement failure for 301, 718 revision surgeries performed between 2005 and 2010.

Revision surgeries were more commonly performed on women rather than men (58%) and most of the patients were between the ages of 65 to 74. More than 60% of the patients had comorbidity, something else wrong with them besides sore knees, at the time of their knee replacement surgery.

Infection in the prosthetic knee joint (periprosthetic joint infection) was the most common reason for revision (25% of patients), and mechanical loosening was the cause in 18.5% of the cases. The TKR procedures were more commonly performed in large urban non-teaching hospitals in the Southern and Midwestern regions of the United States.

Elderly and female patients with a moderate number of comorbidities represented the largest proportion of the revision population. The authors suggest that optimizing patient health before surgery and paying meticulous attention to efforts by the surgical team to minimize the risk of periprosthetic joint infection may decrease the number of knee replacement revisions.