Why reintervention after total knee arthroplasty fails? A consecutive cohort of 1170 surgeries.

Abstract Introduction The aim of this study was to analyze why contemporary reintervention after total knee arthroplasty (RiTKA) fails. Method Between January 2006 and December 2010, from a multicenter cohort of 1170 RiTKAs, we assessed all failures of RiTKA requiring additional surgery. All indications for the index reintervention were included. The minimum follow-up was 3 years. Outcomes 192 (16.4%) patients required additional surgery after RiTKA (re-reintervention). The mean follow-up was 7.7 years. Mean age was 69.2 years old. The mean time to re-reintervention was 9.6 months with 90.1% of rTKA failure occurring within the first two years. Infection was the main cause of new surgery after RiTKA (47.9%; n = 92/192). Other causes included extensor mechanism pathology (14.6%), stiffness (13.5%), pain (6.8%), aseptic loosening (5.2%), laxity (5.2%), periprosthetic fracture (3.6%), and wound pathology (3.1%). In four groups, the main indication for re-reintervention was recurrence of the pathology leading to the first reintervention: RiTKA for infection (59/355, 16.6%, p Discussion Contemporary RiTKA failures mainly occur in the first two postoperative years. Infection is the main cause of failure in RiTKA. Recurrence of the initial pathology occurs in four groups of RiTKA and is the main indication for re-reintervention in these groups; infection (16.6%), stiffness (10.3%) and extensor mechanism failure (5.4%) and pain (2.9%).