Revision TKA: What the Practicing Orthopaedic Surgeon Needs to Know

By David J. Jacofsky, MD, Craig J. Della Valle, MD, R. Michael Meneghini, MD, Scott M. Sporer, MD, and Robert M. Cercek, MD

The Journal of Bone & Joint Surgery d JBJ S .Org volume 92-A d number 5 d May 2010

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

Abstract: Total knee arthroplasties are done commonly, and the overall results are excellent, with 95% of the implants surviving for at least fifteen years1,2. The 5% that fail represent a substantial number, and orthopaedic surgeons are seeing an increasing number of patients who initially had a successful total knee replacement but then had pain, radiographic evidence of failure, and/or dysfunction due to failure of the arthroplasty. Extensive bone loss, instability, infection, dysfunction of the extensor mechanism, and periarticular arthrofibrosis  are frequent challenges encountered during revision surgery. A systematic approach to the evaluation of patients requiring revision total knee arthroplasty can help identify the correct diagnosis and guide the surgical intervention, thereby optimizing success.