Re-revision Total Knee Arthroplasty: Causes, Risk Factors and Results



Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain



The rate of re-revision total knee arthroplasty (TKA) ranges between 4% and 10%, depending on the 
cause of the procedure. Periprosthetic joint infection (PJI) and periprosthetic fracture are the main 
causes of re-revision TKA. The likelihood of implant survival of re-revision TKA diminishes with each 
subsequent revision, with PJI being the main cause of multiple revisions. Acute early asep tic revision 
TKA (within 90 days of surgery) involves a high risk of re-revision at 2 years and a high risk of 
subsequent PJI. The use of antibiotic-loaded cement is associated with lower risk of re-revision. 
Patients younger than 50 years experiencing aseptic revision TKA have a 1 in 3 risk of re-revision. 
Patients revised for instability or having prior TKA revisions have the highest risk of re -revision at 10 
years. Patients younger than 55 years experiencing revision TKA have a 5 -year revision-free survival 
of 80%.
 Level of evidence: III


Main Subjects

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