Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Infection is now the most frequent cause for late revision
12%
334/2713
Polyethylene wear is no longer the major cause for revision
52%
1420/2713
Aseptic loosening is now the most frequent cause for early revision
323/2713
The percentage of revisions for instability and malalignment has increased
10%
263/2713
Stiffness is an uncommon reason for revision procedures
13%
355/2713
Select Answer to see Preferred Response
The use of highly-crosslinked ultra-high molecular weight polyethylene has decreased the revision rate for wear after total knee arthroplasty (TKA) over the past 2 decades. The most common causes for failed primary TKA are aseptic loosening, infection, instability, periprosthetic fracture, and arthrofibrosis. Infection is considered the most common indication for early revision (< 2 years from index procedure) and aseptic loosening is the most common reason for late revision (>2 years). The use of highly crosslinked polyethylene inserts has shown to significantly reduce the complications from polyethylene (PE) wear. Sharkey et al. analyzed the indication for revision following a primary TKA. The reasons for failure (in order of prevalence among the patients in this study) included polyethylene wear, aseptic loosening, instability, infection, arthrofibrosis, malalignment or malposition, deficient extensor mechanism, avascular necrosis in the patella, periprosthetic fracture, and isolated patellar resurfacing. Sharkey et al. published a follow-up study that analyzed the indications for revision 10 years following their index publication. They found that revision for polyethylene wear was no longer the most common indication for revision. They noted that infection was the most common reason for early revision and that aseptic loosening was the most common indication for late revision. They also note that the percentage of revisions for instability and malalignment has decreased. Pitta et al. similarly analyzed failure after primary TKA. The most common reasons for revision within 2 years were infection and stiffness. Risk factors for revision included a history of drug abuse, constrained implants, younger age, and pre-operative trauma or deformity. Illustration A is an example of osteolysis around a TKA from polyethylene wear Incorrect Answers: Answer 1: Infection is the most common cause for early revision (<2 years). Answer 3: Aseptic loosening is the most common cause for late revision (>2 years). Answer 4: The percentage of revisions for instability and malalignment has decreased. Answer 5: Stiffness is a common reason for early revision.
1.6
(8)
Please Login to add comment