Rerevision

Knee » Survival » Rerevision » Overall second revision

FIGURE Cumulative second revision percentage of total knee arthroplasty after a one-stage first revision in the Netherlands in 2007-2019 (n=7,523)

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TABLE Cumulative second revision percentages

  Competing Risk¹ (95% CI) Kaplan Meier (95% CI)
1-year second revision (%) 5.2 (4.7-5.8) 5.2 (4.7-5.7)
3-year second revision (%) 11.0 (10.2-11.8) 11.1 (10.3-11.9)
5-year second revision (%) 13.6 (12.7-14.6) 13.9 (12.9-14.8)

¹ The cumulative revision percentage using the competing risk method is shown in the figure.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
CI: confidence interval.

© LROI 2020

Knee » Survival » Rerevision » By type of first revision

FIGURE Cumulative second revision percentage of total knee arthroplasty after a one-stage first revision by type of first revision in the Netherlands in 2007-2019 (n=7,252)

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TABLE Cumulative second revision percentages

  Number (n) Competing Risk¹ (95% CI) Kaplan Meier (95% CI)
Major first revision 4,178
1-year second revision (%) 2.4 (2.0-3.0) 2.4 (1.9-2.9)
3-year second revision (%) 6.4 (5.6-7.3) 6.5 (5.6-7.3)
5-year second revision (%) 8.8 (7.8-9.9) 9.0 (7.9-10.0)
Minor first revision 3,074
1-year second revision (%) 8.6 (7.7-9.7) 8.6 (7.6-9.6)
3-year second revision (%) 16.7 (15.3-18.2) 17.0 (15.5-18.5)
5-year second revision (%) 19.8 (18.1-21.6) 20.3 (18.5-22.1)

¹ The cumulative revision percentage using the competing risk method is shown in the figure.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
Major revision: revision of at least the femur or tibia component.
Minor revision: only insert and/or patella exchange.
CI: confidence interval.

© LROI 2020

Knee » Survival » Rerevision » By time to first revision

FIGURE Cumulative second revision percentage of total knee arthroplasty after a one-stage first revision by time to first revision in the Netherlands in 2007-2019 (n=6,500)

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TABLE Cumulative second revision percentages

  Number (n) Competing Risk¹ (95% CI) Kaplan Meier (95% CI)
First revision within 1 year 2,031
1-year second revision (%) 10.6 (9.3-12.1) 10.5 (9.2-11.9)
3-year second revision (%) 16.4 (14.7-18.2) 16.5 (14.8-18.3)
5-year second revision (%) 18.0 (16.2-20.0) 18.3 (16.4-20.2)
First revision within 1-3 years 3,380
1-year second revision (%) 3.3 (2.7-3.9) 3.2 (2.6-3.8)
3-year second revision (%) 9.4 (8.4-10.6) 9.5 (8.4-10.6)
5-year second revision (%) 12.6 (11.4-14.1) 12.9 (11.5-14.2)
First revision within 3-5 years 1,089
1-year second revision (%) 3.5 (2.6-4.9) 3.4 (2.3-4.6)
3-year second revision (%) 8.1 (6.5-10.2) 8.2 (6.4-10.1)
5-year second revision (%) 11.0 (8.9-13.7) 11.3 (8.9-13.8)

¹ The cumulative revision percentage using the competing risk method is shown in the figure.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.
CI: confidence interval.

© LROI 2020

Knee » Survival » Rerevision » Reasons for second revision by type of first revision

TABLE Reasons for second revision within five years in patients who underwent a second revision after a one-stage first revision of a total knee arthroplasty by type of first revision in the Netherlands in 2007-2019

Major first revision¹ (n=264) Minor first revision² (n=461) Any type of first revision³ (n=773)
Reasons for second revision Proportion4 (%) Proportion4 (%) Proportion4 (%)
Infection 26.1 44.5 38.1
Instability 28.0 27.8 27.4
Loosening of tibia component 20.8 13.9 16.6
Patellar pain 14.4 9.8 11.8
Malalignment 7.6 10.4 9.7
Loosening of femur component 12.5 3.9 7.5
Arthrofibrosis 6.8 5.4 6.1
Patellar dislocation 4.2 4.3 4.0
Loosening of patella component 1.1 1.5 1.6
Insert wear 0.4 1.5 1.2
Periprosthetic fracture 0.8 0.7 0.6
Progression of osteoarthritis 0.0 0.2 0.1
Other 9.8 6.1 7.4

¹ Revision of at least the femur or tibia component.
² Only insert and/or patella exchange.
³ Any type of revision includes minor and major revisions as well as revision procedures that could not be classified as minor or major revision.
4 One patient may have more than one reason for revision or re-surgery. As such, the total proportion is over 100%.
One-stage revision: A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis.

© LROI 2020