Abstract
There is limited information in English literature regarding the cause of revision
total knee arthroplasty (TKA) in emerging economies. The purpose of this study is
to report a detailed analysis of the TKA failure mechanisms from a referral hospital
in India and to determine whether the failure mechanisms of primary TKA are different
from that of the western world. A total of 53 revision TKAs performed at our institution
over the past 5 years were identified. The revision TKA group was divided into subgroups
according to the cause of failure, including infection, aseptic loosening, periprosthetic
fracture, instability, extensor mechanism failure, and other causes. All revision
TKA patients were subdivided into early (less than 2 years from primary) and late
(more than 2 years from primary) failure groups depending upon the time interval between
primary TKA and revision procedure. The overall common failure mechanisms were infection
(73.58%), aseptic loosening (13.2%), and periprosthetic fracture (5.6%). Infection
was the most common failure mechanism for early revision (< 2 years from primary)
and aseptic loosening was the most common reason for late revision. Our study shows
a pattern similar to the earliest trends of revision TKA in western literature reporting
infection as the major cause for revision. The level of evidence for the study is
Level 3.
Keywords
revision total knee arthroplasty - failure mechanisms - emerging economies
