Mid- and long-term revision

By type of revision
By procedure year
By procedure side
By pre-PROM
By complete PROM (pre, 6mnd, 12mnd)
By pre-OKS
By gender
By age categor y
By diagnosis
By ASA score
By BMI category
By Charnley score
By smoking

Knee » Survival TKA » Mid- and long-term revision » by type of revision

FIGURE Cumulative revision percentage of total knee arthroplasties by type of revision in the Netherlands in 2007-2022 (n=335,039)

TABLE Cumulative revision percentages

	Number at risk (n)	Competing Risk (95% CI)	Kaplan Meier¹ (95% CI)
Any type of revision
1-year revision (%)	304,549	1.0 (1.0-1.1)	0.9 (0.9-1.0)
3-year revision (%)	252,296	3.3 (3.2-3.3)	3.3 (3.2-3.3)
5-year revision (%)	194,494	4.2 (4.1-4.2)	4.2 (4.2-4.3)
10-year revision (%)	73,177	5.5 (5.4-5.6)	5.7 (5.6-5.8)
14-year revision (%)	13,062	6.2 (6.1-6.3)	6.7 (6.6-6.9)
Major revision²
1-year revision (%)	305,942	0.4 (0.4-0.5)	0.4 (0.3-0.4)
3-year revision (%)	256,416	1.6 (1.5-1.6)	1.6 (1.5-1.6)
5-year revision (%)	198,506	2.2 (2.1-2.2)	2.2 (2.1-2.2)
10-year revision (%)	75,118	3.1 (3.0-3.1)	3.2 (3.2-3.3)
14-year revision (%)	13,463	3.5 (3.4-3.6)	3.9 (3.8-4.0)
Minor revision³
1-year revision (%)	305,581	0.6 (0.6-0.7)	0.6 (0.6-0.6)
3-year revision (%)	256,236	1.7 (1.7-1.8)	1.8 (1.8-1.9)
5-year revision (%)	198,965	2.1 (2.1-2.2)	2.3 (2.2-2.3)
10-year revision (%)	76,046	2.6 (2.6-2.7)	2.9 (2.8-2.9)
14-year revision (%)	13,665	2.9 (2.8-3.0)	3.3 (3.2-3.4)

¹ The cumulative revision percentage using the Kaplan Meier method is shown in the figure.
² First revision of the femur or tibia component, regardless of whether a minor revision has already taken place. Therefor, the first three revision procedures were reviewed.
³ Only insert and/or patella exchange (including patella addition).
Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

In 2007-2022, 44,088 (13.2%) primary TKAs were implanted in patients who died within fourteen years after the primary diagnosis

Knee » Survival TKA » Mid- and long-term revision » by procedure year

FIGURE Cumulative major revision percentage of total knee arthroplasties by procedure year of primary TKA in the Netherlands in 2009-2022 (n=256,136)

TABLE Cumulative major revision percentages

		Cumulative major revision percentages – Kaplan Meier (95% CI)
Procedure year primary TKA for osteoarthritis	Number (n)	1yr	3yr	5yr	7yr	10yr	13yr
2009-2010	33,148	0.35 (0.28-0.41)	1.68 (1.54-1.82)	2.40 (2.23-2.57)	2.87 (2.69-3.05)	3.52 (3.32-3.72)	4.08 (3.85-4.31)
2011-2012	39,145	0.41 (0.34-0.47)	1.82 (1.69-1.95)	2.52 (2.36-2.68)	2.97 (2.80-3.14)	3.52 (3.33-3.71)	n.a.
2013-2014	44,035	0.40 (0.34-0.46)	1.82 (1.69-1.95)	2.44 (2.29-2.59)	2.91 (2.75-3.07)	3.55 (3.34-3.76)	n.a.
2015-2016	46,940	0.43 (0.37-0.49)	1.63 (1.51-1.75)	2.21 (2.08-2.34)	2.59 (2.44-2.74)	n.a.	n.a.
2017-2018	49,370	0.33 (0.28-0.38)	1.38 (1.28-1.48)	1.88 (1.76-2.00)	n.a.	n.a.	n.a.
2019-2020	43,498	0.28 (0.23-0.33)	1.17 (1.06-1.28)	n.a.	n.a.	n.a.	n.a.

Major revision precentage: first revision of the femur or tibia component, regardless of whether a minor revision has already taken place. Therefor, the first three revision procedures were reviewed.
TKA: total knee arthroplasty; CI: confidence interval; n.a. if <50 cases were at risk.

Knee » Survival TKA » Mid- and long-term revision » by procedure side

FIGURE Cumulative major revision percentage of total knee arthroplasties for osteoarthritis by procedure side in the Netherlands in 2007-2022 (n=319,487)

TABLE Cumulative major revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	10yr	14yr
Procedure side
Left	150,733	0.4 (0.3-0.4)	1.5 (1.5-1.6)	2.1 (2.0-2.2)	2.5 (2.4-2.6)	3.1 (3.0-3.2)	3.8 (3.6-4.0)
Right	168,754	0.4 (0.3-0.4)	1.6 (1.5-1.6)	2.2 (2.1-2.3)	2.7 (2.6-2.7)	3.3 (3.1-3.4)	3.9 (3.7-4.0)

Major revision precentage: first revision of the femur or tibia component, regardless of whether a minor revision has already taken place. Therefor, the first three revision procedures were reviewed.
Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

Knee » Survival TKA » Mid- and long-term revision » by pre-PROM

FIGURE Cumulative revision percentage of total knee arthroplasties by valid pre-operative PROM of patients who underwent a TKA for osteoarthritis in the Netherlands in 2014-2022 (n=209,153)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	9yr
Pre-PROM
Valid	93,414	1.0 (0.9-1.1)	3.1 (3.0-3.3)	4.1 (3.9-4.2)	4.7 (4.5-4.8)	n.a.
Invalid	115,739	1.0 (1.0-1.1)	3.3 (3.2-3.4)	4.1 (4.0-4.3)	4.7 (4.6-4.9)	5.3 (5.1-5.5)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
Valid: pre-operative PROM reported; Invalid: non-responders to pre-operative PROM; PROM: patient reported outcome measure.
TKA: total knee arthroplasty; CI: confidence interval; n.a. if <50 cases were at risk..

Knee » Survival TKA » Mid- and long-term revision » by complete PROM (pre, 6mnd, 12mnd)

FIGURE Cumulative revision percentage of total knee arthroplasties by complete PROM (pre-, 6mnd, 12mnd) of patients who underwent a TKA for osteoarthritis in the Netherlands in 2014-2022 (n=209,153)

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TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	9yr
Reported pre-, 6mnd and 12mnd PROM
Complete	40,843	0.7 (0.6-0.7)	2.7 (2.6-2.9)	3.6 (3.4-3.9)	4.2 (3.9-4.5)	n.a.
Incomplete	168,310	1.1 (1.1-1.2)	3.4 (3.3-3.4)	4.2 (4.1-4.4)	4.8 (4.7-4.9)	5.4 (5.2-5.6)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
Complete: pre-operative, 6 and 12 months postoperative PROM reported; Incomplete: one or more PROMs missing; PROM: patient reported outcome measure.
TKA: total knee arthroplasty; CI: confidence interval; n.a. if <50 cases were at risk..

Knee » Survival TKA » Mid- and long-term revision » by pre-OKS

FIGURE Cumulative revision percentage of total knee arthroplasties by pre-operative Oxford Knee score of patients who underwent a TKA for osteoarthritis in the Netherlands in 2014-2022 (n=82,169)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr
Pre-operative Oxford Knee score
0 to 19	27,098	1.2 (1.0-1.3)	3.8 (3.6-4.1)	4.9 (4.6-5.2)	5.8 (5.3-6.2)
20 to 29	38,295	0.9 (0.8-1.0)	2.9 (2.7-3.1)	3.8 (3.6-4.1)	4.3 (4.0-4.6)
30 to 39	15,447	0.9 (0.7-1.1)	2.6 (2.3-2.8)	3.4 (3.1-3.8)	3.9 (3.4-4.3)
40 to 48	1,329	0.3 (0.0-0.6)	1.3 (0.6-2.0)	2.6 (1.4-3.8)	2.6 (1.4-3.8)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

The Oxford Knee score measures the physical functioning and pain of patients with osteoarthritis to the knee. The score has a range of 0.0 to 48.0, with 0.0 representing no functional ability and 48.0 the most functional ability.

Knee » Survival TKA » Mid- and long-term revision » by gender

FIGURE Cumulative revision percentage of total knee arthroplasties by gender in the Netherlands in 2007-2022 (n=334,562)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	10yr	14yr
Gender
Men	118,431	1.1 (1.0-1.1)	3.4 (3.3-3.5)	4.4 (4.2-4.5)	5.1 (4.9-5.2)	6.1 (5.9-6.2)	7.3 (7.0-7.6)
Women	216,131	0.9 (0.8-0.9)	3.2 (3.1-3.2)	4.2 (4.1-4.2)	4.8 (4.7-4.9)	5.6 (5.5-5.7)	6.5 (6.3-6.6)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

Knee » Survival TKA » Mid- and long-term revision » by age category

FIGURE Cumulative revision percentage of total knee arthroplasties by age category in the Netherlands in 2007-2022 (n=334,768)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	10yr	14yr
Age (years)
<50	7,092	1.4 (1.1-1.6)	6.9 (6.3-7.5)	9.5 (8.7-10.2)	11.3 (10.5-12.1)	13.7 (12.8-14.7)	16.7 (15.4-18.0)
50-59	47,820	1.1 (1.0-1.2)	4.8 (4.6-5.0)	6.5 (6.3-6.7)	7.6 (7.4-7.9)	9.2 (8.8-9.5)	11.4 (10.9-11.8)
60-69	116,413	0.9 (0.8-0.9)	3.3 (3.2-3.4)	4.4 (4.2-4.5)	5.1 (5.0-5.2)	6.1 (5.9-6.2)	7.1 (6.9-7.4)
70-79	122,783	0.9 (0.9-1.0)	2.7 (2.6-2.8)	3.4 (3.3-3.6)	3.9 (3.8-4.0)	4.3 (4.2-4.4)	4.6 (4.4-4.7)
≥80	40,660	1.0 (0.9-1.1)	2.0 (1.9-2.2)	2.3 (2.2-2.5)	2.5 (2.3-2.6)	2.6 (2.4-2.7)	2.6 (2.4-2.8)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

Knee » Survival » Mid- and long-term revision » by diagnosis

FIGURE Cumulative revision percentage of total knee arthroplasties by diagnosis in the Netherlands in 2007-2022 (n=332,243)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	10yr	14yr
Diagnosis
Osteoarthritis	319,800	0.9 (0.9-1.0)	3.2 (3.2-3.3)	4.2 (4.1-4.3)	4.8 (4.7-4.9)	5.7 (5.6-5.8)	6.7 (6.5-6.8)
Other	12,443	1.6 (1.4-1.8)	4.3 (3.9-4.7)	5.6 (5.2-6.0)	6.6 (6.1-7.1)	7.7 (7.1-8.3)	8.4 (7.7-9.1)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

Knee » Survival TKA » Mid- and long-term revision » by ASA score

FIGURE Cumulative revision percentage of total knee arthroplasties by ASA score in the Netherlands in 2007-2022 (n=325,686)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	10yr	14yr
ASA score
I	50,427	0.8 (0.7-0.9)	3.4 (3.3-3.6)	4.5 (4.3-4.7)	5.3 (5.1-5.5)	6.4 (6.2-6.7)	8.1 (7.7-8.5)
II	215,604	0.9 (0.8-0.9)	3.2 (3.1-3.2)	4.1 (4.0-4.2)	4.8 (4.6-4.9)	5.6 (5.4-5.7)	6.3 (6.1-6.5)
III-IV	59,655	1.3 (1.2-1.4)	3.5 (3.3-3.7)	4.5 (4.3-4.7)	5.1 (4.9-5.3)	5.7 (5.5-6.0)	6.4 (6.0-6.8)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

Knee » Survival TKA » Mid- and long-term revision » by BMI category

FIGURE Cumulative revision percentage of total knee arthroplasties by BMI category in the Netherlands in 2014-2022 (n=214,605)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	9yr
Body Mass Index (kg/m²)
Underweight (≤18,5)	383	2.0 (0.5-3.4)	5.4 (2.9-7.9)	5.4 (2.9-7.9)	6.5 (3.2-9.7)	n.a.
Normal weight (>18,5-25)	37,692	0.9 (0.8-1.0)	2.9 (2.7-3.1)	3.6 (3.4-3.9)	4.3 (4.0-4.6)	4.9 (4.5-5.3)
Overweight (>25-30)	88,356	1.0 (0.9-1.1)	3.2 (3.0-3.3)	4.1 (3.9-4.2)	4.6 (4.5-4.8)	5.2 (4.9-5.4)
Obesity (>30-40)	80,774	1.1 (1.0-1.1)	3.5 (3.3-3.6)	4.5 (4.3-4.6)	5.2 (5.0-5.4)	5.8 (5.5-6.1)
Morbid obesity (>40)	7,400	1.9 (1.6-2.2)	3.9 (3.4-4.3)	4.7 (4.1-5.2)	5.4 (4.7-6.0)	n.a.

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval; n.a. if <50 cases were at risk.

Knee » Survival TKA » Mid- and long-term revision» by Charnley score

FIGURE Cumulative revision percentage of total knee arthroplasties by charnley score in the Netherlands in 2014-2022 (n=213,908)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	9yr
Charnley-score
A One knee joint affected	85,877	1.1 (1.0-1.1)	3.9 (3.7-4.0)	5.0 (4.8-5.2)	5.7 (5.5-5.9)	6.4 (6.1-6.7)
B1 Both knee joints affected	73,927	0.9 (0.9-1.0)	2.8 (2.7-3.0)	3.7 (3.5-3.8)	4.3 (4.1-4.5)	4.8 (4.6-5.1)
B2 Contralateral knee joint with a total knee prosthesis	46,800	1.1 (1.0-1.2)	2.6 (2.5-2.8)	3.2 (3.0-3.4)	3.7 (3.5-4.0)	4.0 (3.7-4.3)
C Multiple joints affected or chronic disease that affects quality of life	7,304	1.5 (1.2-1.8)	3.5 (3.0-3.9)	4.3 (3.7-4.8)	4.9 (4.2-5.5)	n.a.

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval; n.a. if <50 cases were at risk.

Knee » Survival TKA » Mid- and long-term revision » by smoking

FIGURE Cumulative revision percentage of total knee arthroplasties by smoking in the Netherlands in 2014-2022 (n=210,312)

TABLE Cumulative revision percentages

		Cumulative revision percentages – Kaplan Meier (95% CI)
	Number (n)	1yr	3yr	5yr	7yr	9yr
Smoking
No	193,046	1.0 (1.0-1.1)	3.2 (3.1-3.3)	4.1 (4.0-4.2)	4.8 (4.6-4.9)	5.3 (5.1-5.5)
Yes	17,266	1.4 (1.2-1.6)	4.2 (3.9-4.5)	5.3 (4.9-5.7)	6.0 (5.6-6.5)	6.9 (6.2-7.6)

Please note: Dotted lines represent the upper and lower limits of the 95% confidence interval.
TKA: total knee arthroplasty; CI: confidence interval.

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