Numbers
9 years up to 31 December 2009
- 289 000 TKR
- 80% primary
- 11% primary partial
- 8.5% revision
TKR Revision Rate
9 year revision rate of 5.1% OA
- 4.5% in RA
Causes
- loosening 30%
- infection 20%
- PFJ 14%
- pain 9%
- instability 5%
Risks
- males
- < 55
9 year revision by age
< 55 11.1%
55-64 6.9%
65-74 4.9%
> 75 2.6%
9 year by gender
Male 5.7%
Female 4.6%
9 year by Bearing
Fixed 4.7%
Mobile Rotating 5.7%
Mobile Slding 6.7%
9 year by Constraint
Minimal 4.8%
Posterior Stabilised 6.0%
9 year by Patella Resurfacing
No Patella Resurfacing 5.5%
- CR 5.2%
- PS 7.8%
Patella Resurfacing 4.4%
- CR 4.3%
- PS 4.6%
9 year by Fixation
Cemented 5.0%
Cementless 5.2%
Hybrid 4.9%
9 year by Cemented Prosthesis
Nexgen CR 2.9%
Nexgen LPS 4.4%
PFC 4.1%
Genesis II 4.5%
Scorpio 5.2%
LCS 6.0%
9 year by cementless prosthesis
Nexgen CR 3.7%%
LCS 5.9%
Advantim 1.5%
Primary Patella/Trochlea Resurfacing
7 year revision rate of 22.4%
- males and young age highest risk revision
Cause
- progression of disease 35%
- loosening 21%
- pain 11%
7 year revision by prosthesis
Avon 17.9%
7 year revision by age
< 65 24.6%
5 year revision by gender
Male 20.7%
Female 13.5%
Unicompartmental Knee Replacement
9 year revision rate of 13.3%
- young age and females highest risk revison
Cause
- loosening 50%
- progression of disease 20%
- pain 12%
9 year revision by age
< 55 19.7%
55-64 15.6%
65-74 11.1%
> 75 8.8%
9 year revision by gender
Male 12.1%
Female 14.5%
9 year by prosthesis
Oxford 3 13.1%
M/G 9.9%
Revision TKR
Types
- femur + tibia 48%
- tibia only 8%
- femur only 4%
- insert only 13%
- patella only 10%
- patella + insert 7%
Indications
Loosening 42%
Infection 18%
Pain 6%
PF pain 6%
Wear tibial 6%
7 year revision of revision Uni to TKR
Re-revision TKR 17.1%
7 year revision of Revision Primary
Re-revision TKR 22%