Major Aseptic Revision Following Total Knee Replacement: A Study of 478,081 Total Knee Replacements from the Australian Orthopaedic Association National Joint Replacement Registry

• Published in: Journal of bone and joint surgery. American volume 2019-02, Vol.101 (4), p.302-310
• Main Authors: Jorgensen, Nicholas B., McAuliffe, Michael, Orschulok, Thomas, Lorimer, Michelle F., de Steiger, Richard
• Format: Article
• Language: English
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/JBJS.17.01528

Major revision is associated with less satisfactory outcomes, substantial complications, and added cost. Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were analyzed to identify factors associated with major aseptic revision (MAR) of primary total knee replacement (TKR). The cumulative percent major aseptic revision rate following all primary TKRs performed in Australia from September 1, 1999, to December 31, 2015, was assessed. Kaplan-Meier estimates of survivorship were utilized to describe the time to first revision. Hazard ratios (HRs) from Cox proportional hazard models, adjusted for age and sex, were utilized to compare revision rates. There were 5,973 MARs recorded from the total cohort of 478,081 primary TKRs. The cumulative percent MAR at 15 years was 3.0% (95% confidence interval [CI], 2.8% to 3.2%). Fixed bearings had a significantly lower rate of MAR at 15 years: 2.7% (95% CI, 2.4% to 2.9%) compared with 4.1% (95% CI, 3.8% to 4.5%) for mobile bearings (HR, 1.77 [95% CI, 1.68 to 1.86]; p < 0.001). Age had a significant effect on MAR rates, with a cumulative percent revision at 15 years for patients