Introduction. Recent literature has shown increasing interest in analysing return to theatre (RTT) as a quality indicator across different surgical specialities. The aim of this study is to express “RTT at 90 days” as a useful predictor in identifying complications following primary total knee replacement (TKR). Methods. Patients who had been to theatre within 90 days of primary TKR were identified and their clinical notes were reviewed. Patients’ co morbidities, surgeon's grade, details of revision procedures and their final outcome were analysed. Results. Between 2010 and 2012 a total of 1388 primary TKR were performed. Eleven patients, 11/1388 (0.79%) RTT within 90 days, mean age was 71 years (51 to 85), mean body mass index (BMI) was 30.7 (21 to 45). Out of these 11 patients, six had Manipulation Under Anaesthesia (MUA) for stiffness, two had wound exploration and primary closure and three patients underwent revision arthroplasty following failed salvage procedures. Conclusion. Using RTT as a quality marker, it is possible to assess performance of surgeons and institutions much quicker than with joint registry. Our results showed that RTT at 90 days for TKR in our institution is significantly lower than national average (0.79% versus 1.8%)