Document Detail

What are the causes of revision total knee arthroplasty in Japan?
MedLine Citation:
PMID:  23385774     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries.
QUESTIONS/PURPOSES: We therefore determined (1) causes of revision TKA in a cohort of Japanese patients with revision TKA and (2) whether patient demographic features and underlying diagnosis of primary TKA are associated with the causes of revision TKA.
METHODS: We assessed all revision TKA procedures performed at five major centers in Hokkaido from 2006 to 2011 for the causes of failures. Demographic data and underlying diagnosis for index primary TKA of the revision cases were compared to those of randomly selected primary TKAs during the same period.
RESULTS: One hundred forty revision TKAs and 4047 primary TKAs were performed at the five centers, indicating a revision burden of 3.3%. The most common cause of revision TKA was mechanical loosening (40%) followed by infection (24%), wear/osteolysis (9%), instability (9%), implant failure (6%), periprosthetic fracture (4%), and other reasons (8%). The mean age of patients with periprosthetic fracture was older (77 versus 72 years) and the male proportion in patients with infection was higher (33% versus 19%) than those of patients in the primary TKA group. There was no difference in BMI between primary TKAs and any type of revision TKA except other causes.
CONCLUSIONS: The revision burden at the five referral centers in Hokkaido was 3.3%, and the most common cause of revision TKA was mechanical loosening followed by infection. Demographic data such as age and sex might be associated with particular causes of revision TKA.
Yasuhiko Kasahara; Tokifumi Majima; Shoichi Kimura; Osamu Nishiike; Jun Uchida
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-05-22     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1533-8     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Arthroplasty, Replacement, Knee / adverse effects*,  instrumentation*
Asian Continental Ancestry Group*
Biomechanical Phenomena
Chi-Square Distribution
Fractures, Bone / ethnology,  surgery
Japan / epidemiology
Knee Joint / physiopathology,  radiography,  surgery*
Knee Prosthesis*
Life Style / ethnology
Middle Aged
Multivariate Analysis
Odds Ratio
Osteolysis / ethnology,  surgery
Postoperative Complications / ethnology,  surgery*
Prosthesis Failure
Prosthesis-Related Infections / ethnology,  surgery
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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