Why Are Knee Replacements Failing Today

Description: Severe degenerative joint disease (DJD) of the knee results in pain, limited function, and a poorer quality of life. Total knee arthroplasty (TKA) is a safe and effective treatment of severe DJD of the knee. Patient satisfaction rates after TKA range from 90% to 95%.[1,2] The high satisfaction rate is dependent on the following factors: patient selection; implant design; surgical technique; and postoperative rehabilitation and compliance. However, TKA can fail, requiring that the patient undergo revision surgery. Annually, 35,000 TKAs are revised worldwide.[3] The published literature finds the following as the causes for failure of TKA: Infection; Loosening; Instability; Patellofemoral complications; Prosthesis fracture; and Polyethylene wear.[4-6] At The American Academy of Orthopaedic Surgeons 69th Annual Meeting, held in Dallas, Texas in February 2002, Dr. Peter F. Sharkey, from Philadelphia, Pennsylvania, and his colleagues[3] presented data describing the mechanisms of failure in a series of revision TKAs performed between September 1997 and October 2000. These investigators conducted a retrospective review of 212 consecutive TKAs in 203 patients who underwent total knee revision at the Rothman Institute in Philadelphia, Pennsylvania.