The Epidemiology of Revision Total Knee Arthroplasty in the United StatesReport as inadecuate

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Clinical Orthopaedics and Related Research®

, Volume 468, Issue 1, pp 45–51

First Online: 25 June 2009Received: 21 October 2008Accepted: 05 June 2009DOI: 10.1007-s11999-009-0945-0

Cite this article as: Bozic, K.J., Kurtz, S.M., Lau, E. et al. Clin Orthop Relat Res 2010 468: 45. doi:10.1007-s11999-009-0945-0


Understanding the cause of failure and type of revision total knee arthroplasty TKA procedures performed in the United States is essential in guiding research, implant design, and clinical decision making in TKA. We assessed the causes of failure and specific types of revision TKA procedures performed in the United States using newly implemented ICD-9-CM diagnosis and procedure codes related to revision TKA data from the Nationwide Inpatient Sample NIS database. Clinical, demographic, and economic data were reviewed and analyzed from 60,355 revision TKA procedures performed in the United States between October 1, 2005 and December 31, 2006. The most common causes of revision TKA were infection 25.2% and implant loosening 16.1%, and the most common type of revision TKA procedure reported was all component revision 35.2%. Revision TKA procedures were most commonly performed in large, urban, nonteaching hospitals in Medicare patients ages 65 to 74. The average length of hospital stay LOS for all revision TKA procedures was 5.1 days, and the average total charges were $49,360. However, average LOS, average charges, and procedure frequencies varied considerably by census region, hospital type, and procedure performed.

Level of Evidence: Level II, economic and decision analysis. See Guidelines for Authors for a complete description of levels of evidence.

One of more of the authors KJB received financial support from the Orthopaedic Research and Education Foundation. One or more of the authors SMK, KO, EL are employees of Exponent, Inc. One or more of the authors DJB, TPV receive consulting income and royalties from DePuy, Inc. One author HER receives royalties from Zimmer, Inc.

This work was performed at the University of California, San Francisco and Exponent, Inc.

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Author: Kevin J. Bozic - Steven M. Kurtz - Edmund Lau - Kevin Ong - Vanessa Chiu - Thomas P. Vail - Harry E. Rubash - Daniel J


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