Revision within 1 and 3 years

By type of revision
Overall revision per hospital
Major revision per hospital
Reasons for revision by type of revision
Type of revision per year
Time after primary TKA

Knee » Survival » Revision within 1 and 3 years » By type of revision

TABLE Cumulative 1-year and 3-year revision percentage of primary total knee arthroplasties by type of revision in the Netherlands in 2013-2017 (n=120,845)

	Cumulative 1-year revision percentage		Cumulative 3-year revision percentage
	Competing Risk (95% CI)	Kaplan Meier (95% CI)	Competing Risk (95% CI)	Kaplan Meier (95% CI)
Any type of revision¹	1.1 (1.0-1.2)	1.0 (0.9-1.1)	3.5 (3.4-3.6)	3.5 (3.4-3.6)
Major revision²	0.4 (0.4-0.5)	0.4 (0.3-0.4)	1.5 (1.5-1.6)	1.5 (1.5-1.6)
Minor revision³	0.7 (0.6-0.7)	0.6 (0.6-0.7)	1.9 (1.8-2.0)	1.9 (1.8-1.9)

¹ Any type of revision includes minor and major revisions as well as revision procedures that could not be classified as minor or major revision.
² Revision of at least the femur or tibia component.
³ Only insert and/or patella exchange (including patella addition).
CI: confidence interval.

In 2013-2017, 3,687 (3.1%) primary TKAs were implanted in patients who died within three years after the primary procedure.

Knee » Survival » Revision within 1 and 3 years » Overall revision per hospital

FIGURE Funnel plot of proportion of knee revision arthroplasties within three years after a total knee arthroplasty per hospital in the Netherlands in 2013-2017 (n=120,301)

Please note: The proportion of revisions within 3 years per hospital were adjusted for casemix factors age, gender, ASA score and diagnosis (osteoarthritis versus other).
TKA: total knee arthroplasty; CL: control limits; CI: confidence interval.

The mean 3-years revision percentage is 3.5 (95% CI: 3.4-3.6 ) in the Netherlands in 2013-2017.
Control limits indicate the plausible range of outcome if all hospitals perform equally well.

Knee » Survival » Revision within 1 and 3 years » Major revision per hospital

FIGURE Funnel plot of proportion of knee major revision arthroplasties within three years after a total knee arthroplasty per hospital in the Netherlands in 2013-2017 (n=120,301)

Please note: Major revision is defined as revision of at least femur or tibia component.
Please note: The proportion of revisions within 3 years per hospital were adjusted for casemix factors age, gender, ASA score and diagnosis (osteoarthritis versus other).
TKA: total knee arthroplasty; CL: control limits; CI: confidence interval.

The mean 3-years major revision percentage is 1.5 (95% CI: 1.5-1.6) in the Netherlands in 2013-2017.
Control limits indicate the plausible range of outcome if all hospitals perform equally well.

Knee » Survival » Revision within 1 and 3 years » Reasons for revision by type of revision

TABLE Reasons for revision within three years in patients that underwent a knee revision arthroplasty by type of revision in the Netherlands in 2013-2017

	Major revision¹ (n=1,871)	Minor revision² (n=2,294)	Any type of revision³ (n=4,272)
Reasons for revision	Proportion⁴ (%)	Proportion⁴ (%)	Proportion⁴ (%)
Patellar pain	9.5	46.8	30.0
Instability	32.7	23.9	27.2
Infection	17.3	21.0	19.4
Loosening of tibia component	35.3	0.7	16.0
Malalignment	28.9	1.6	13.6
Arthrofibrosis	7.7	6.7	7.2
Loosening of femur component	9.2	0.2	4.1
Patellar dislocation	2.4	3.7	3.1
Periprosthetic fracture	4.4	0.3	2.2
Revision after knee removal	3.6	0.2	1.7
Insert wear	0.9	2.2	1.6
Loosening of patella component	0.4	0.9	0.7
Progression of osteoarthritis	0.3	0.6	0.5
Other	7.4	8.6	8.1

¹ Revision of at least the femur or tibia component.
² Only insert and/or patella exchange (including patella addition).
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%.

Knee » Survival » Revision within 1 and 3 years » Type of revision per year

TABLE Type of revision within one year after a primary total knee arthroplasty in the Netherlands in 2013-2017 (n=120,845)

Type of revision	Within 1 year	Within 3 years
Type of revision	Proportion (%)	Proportion (%)
Major revisions	0.4	1.5
Only femur component	0.1	0.2
Only tibia component	0.1	0.3
Femur and tibia component	0.3	1.1
Minor revisions	0.7	1.9
DAIR	0.3	0.4
No DAIR	0.2	0.8
Patella addition	0.1	0.7

Major revision: revision of at least the femur or tibia component.
Minor revision: only inlay and/or patella exchange.
DAIR: minor revision with infection as reason for revision.
TKA: total knee arthroplasty; DAIR: debridement, antibiotics and implant retention.

Knee » Survival » Revision within 1 and 3 years » Time after primary TKA

TABLE Time after primary total knee arthroplasty until short-term revision in the Netherlands in 2013-2017 (n=120,845)

Time after primary TKA	Percentage revisions (%)
Day 0-29	0.3
Day 30-182	0.3
Day 183-364	0.6
Day 365-730 (second year)	1.5
Day 731-1095 (third year)	0.9

TKA: total knee arthroplasty;

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