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Aseptic Failure in Total Knee Arthroplasty

  • Chapter
Total Knee Arthroplasty

Abstract

The burden of revision total knee arthroplasty is significant and is set to increase. Understanding why modern total knee arthroplasty (TKA) fails is imperative if we are to effectively address failure but also to improve outcomes and satisfaction for our patients. Most causes of failure are, to some degree, under the surgeon’s control. Infection remains the first cause of failure to exclude. Aseptic failure of TKA encompasses several mechanisms of failure, some of which are intrinsically linked, namely, loosening, instability and malalignment. Our definitions of mechanisms of failure are becoming more descriptive which will aid in the extraction of meaningful data from large datasets and registries, but as surgeons we have a responsibility to report this data accurately so as to optimize its analysis. The successful development of more resistant biomaterials and evolutions in TKA design has helped reduce rates of polyethylene wear and associated osteolysis, but the work to provide a “lifetime” TKA goes on. Meticulous and accurate surgery to result in a balanced, well-fixed TKA must remain the surgeon’s primary aim in the quest to reduce failure.

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  1. Department of Trauma and Orthopaedics, University College London Hospital, 250 Euston Road, London, NW1 2BU, UK

    Rahul Patel

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  1. "La Paz" University Hospital-IdiPaz, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. University College London Hospitals, London, United Kingdom

    Sam Oussedik

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Patel, R. (2015). Aseptic Failure in Total Knee Arthroplasty. In: Rodríguez-Merchán, E., Oussedik, S. (eds) Total Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-17554-6_16

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