Abstract
Background
A commonly held belief amongst surgeons and patients is that progression of disease (arthritis) to other compartments is a major cause of early failure of UKRs.
Methods
We analysed the NJR database records of 17,643 primary UKRs performed between April 2003 and April 2009. Where these had been revised the reason for revision was noted.
Results
Of the 17,643 primary UKRs, 308 had died and were excluded from the analysis. Of the living, 505 had been revised (3%) at a mean 3.45 years (range 2-6 years) following the primary procedure. Reason for revision was recorded in 472 cases (93%). Aseptic loosening was the commonest cause for revision in 154 cases (33%), followed by non specific pain in 129 cases (27%), bearing dislocation in 58 cases (12%), Instability in 33 cases (7%), Infection 28 cases (6%), progression of disease 23 cases (5%), periprosthetic fracture 19 cases (4%) and malalignment 15 cases (3%). 35% failed within 1 year, 38% within 2 years and 16% within 3 years of the index operation.
Conclusion
Similar findings has been reported on the New Zealand Registry 10 year report where the overall revision rate was 284/4,826 (5.9%), and revision due to disease progression 7.7%. Progression of disease is not a major cause of early failure of UKRs. 73% of the failures occurred within two years of surgery. Other causes such as aseptic loosening, bearing dislocation and instability are more common and could be possibly ameliorated by improved surgical technique, better patient selection and component choice.
