• Arch Orthop Trauma Surg · Dec 2024

    Septic complications are on the rise and aseptic loosening has decreased in total joint arthroplasty: an updated complication based analysis using worldwide arthroplasty registers.

    • Georg Hauer, Laura Rasic, Sebastian Klim, Lukas Leitner, Andreas Leithner, and Patrick Sadoghi.
    • Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, Graz, 8036, Austria. georg.hauer@medunigraz.at.
    • Arch Orthop Trauma Surg. 2024 Dec 1; 144 (12): 519952045199-5204.

    IntroductionA decade ago, a comprehensive study was conducted to investigate the reasons for revision surgeries and their respective frequencies in cases of total hip arthroplasty (THA) and total knee arthroplasty (TKA) based on a complication-based analysis of joint replacement registries. The aim of the present study was to determine whether the causes and risks of their occurrence have changed over the last ten years and to present an updated analysis.Materials And MethodsA systematic review of national arthroplasty registries from seven countries examined the causes and rates of revisions of THA and TKA. The study focused on a descriptive analysis that provided an updated overview without statistical significance values.ResultsThe most common causes for revisions of THA were aseptic loosening (35.1%), deep infection (18.2%), dislocation/instability (15.9%), and periprosthetic fractures (11.4%). The most common causes for revisions of TKA were deep infection (21.6%), aseptic loosening (18.3%), instability (14.1%), and pain (10.9%).ConclusionThe findings of this study revealed significant shifts in the underlying causes of revision surgeries in the last decade. Notably, septic complications emerged as the predominant reason for revision of primary TKA, while they also gained prominence as a cause of failure of THA. Although aseptic loosening remains the primary cause for re-operation of THA, the relative risk has decreased for both THA and TKA.© 2024. The Author(s).

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