Revision within 1 and 3 years

By type of revision within 1 year
By type of revision within 3 years
First major or minor revision
Overall revision per hospital
Major revision per hospital
Reasons for revision by type of revision
Time after primary TKA

Knee » Survival TKA» Revision within 1 and 3 years » By type of revision within 1 year

TABLE Cumulative 1-year revision percentage of primary total knee arthroplasties by type of revision in the Netherlands in 2017-2021 (n=117,934)

	Cumulative 1-year revision percentage
	Kaplan Meier (95% CI)
Any type of revision¹	1.0 (1.0-1.1)
Major revision²	0.3 (0.2-0.3)
Only femur	0.0 (0.0-0.1)
Only tibia	0.1 (0.0-0.1)
Femur and tibia	0.2 (0.1-0.2)
Minor revision³	0.7 (0.7-0.8)
DAIR	0.5 (0.4-0.5)
No DAIR	0.2 (0.2-0.2)
Patella addition	0.1 (0.0-0.1)

¹ Any type of revision includes minor and major revisions as well as revision procedures that could not be classified as minor or major revision.
² Revision of at least the femur or tibia component.
³ Only insert and/or patella exchange (including DAIR procedures).
TKA: total knee arthroplasty; CI: confidence interval.

In 2017-2021, 895 (0.8%) primary TKAs were implanted in patients who died within one year after the primary procedure.

Knee » Survival TKA» Revision within 1 and 3 years » By type of revision within 3 years

TABLE Cumulative 3-year revision percentage of primary total knee arthroplasties by type of revision in the Netherlands in 2015-2019 (n=125,934)

	Cumulative 3-year revision percentage
	Kaplan Meier (95% CI)
Any type of revision¹	3.3 (3.2-3.4)
Major revision²	1.3 (1.3-1.4)
Only femur	0.1 (0.1-0.2)
Only tibia	0.3 (0.2-0.3)
Femur and tibia	0.9 (0.9-1.0)
Minor revision³	1.9 (1.8-2.0)
DAIR	0.5 (0.5-0.6)
No DAIR	0.8 (0.8-0.9)
Patella addition	0.6 (0.5-0.6)

¹ Any type of revision includes minor and major revisions as well as revision procedures that could not be classified as minor or major revision.
² Revision of at least the acetabulum or femur component.
³ Only insert and/or patella exchange (including DAIR procedures).
TKA: total knee arthroplasty; CI: confidence interval.

In 2015-2019, 3,954 (3.1%) primary TKAs were implanted in patients who died within three years after the primary procedure.

Knee » Survival TKA» Revision within 1 and 3 years » First major or minor revision

TABLE Cumulative 3-year first revision percentage of primary total knee arthroplasties by type of first major or first minor revision in the Netherlands in 2015-2019 (n=1125,934)

	Cumulative 3-year first revision percentage
	Kaplan Meier (95% CI)
First major revision¹	1.5 (1.4-1.5)
Femur	1.2 (1.1-1.3)
Tibia	1.3 (1.3-1.4)
First minor revision²	1.9 (1.8-2.0)
Insert	1.3 (1.2-1.4)
Patella	0.9 (0.8-0.9)

In 2015-2019, 3,954 (3.1%) primary TKAs were implanted in patients who died within three years after the primary procedure.

Knee » Survival TKA» Revision within 1 and 3 years » Overall revision per hospital

FIGURE Funnel plot of proportion of knee revision arthroplasties within three years after a total knee arthroplasty per hospital in the Netherlands in 2015-2019 (n=125,934)

Please note: The proportion of revisions within 3 years per hospital were adjusted for casemix factors age, gender, ASA score and diagnosis (osteoarthritis versus other).
TKA: total knee arthroplasty; CL: control limits; CI: confidence interval.

The mean 3-year revision percentage is 3.3 (95% CI: 3.2-3.4 ) in the Netherlands in 2015-2019.
Control limits indicate the plausible range of outcome if all hospitals perform equally well.

Knee » Survival TKA» Revision within 1 and 3 years » Major revision per hospital

FIGURE Funnel plot of proportion of knee major revision arthroplasties within three years after a total knee arthroplasty per hospital in the Netherlands in 2015-2019 (n=125,934)

Please note: Major revision is defined as revision of at least femur or tibia component.
Please note: The proportion of revisions within 3 years per hospital were adjusted for casemix factors age, gender, ASA score and diagnosis (osteoarthritis versus other).
TKA: total knee arthroplasty; CL: control limits; CI: confidence interval.

The mean 3-year major revision percentage is 1.3 (95% CI: 1.3-1.4) in the Netherlands in 2015-2019.
Control limits indicate the plausible range of outcome if all hospitals perform equally well.

Knee » Survival TKA» Revision within 1 and 3 years » Reasons for revision by type of revision

TABLE Reasons for revision within three years of primary total knee arthroplasties by type of revision in the Netherlands in 2015-2019

	Major revision¹ (n=1,858)	Minor revision² (n=2,400)	Any type of revision³ (n=4,176)
Reasons for revision	Proportion⁴ (%)	Proportion⁴ (%)	Proportion⁴ (%)
Patellar pain	8.0	39.8	27.0
Instability	32.2	23.0	26.7
Infection	21.5	28.7	24.1
Loosening of tibia component	32.1	0.6	14.1
Malalignment	26.6	1.6	12.3
Arthrofibrosis	10.0	7.0	8.4
Loosening of femur component	8.1	0.3	3.6
Patellar dislocation	3.8	4.3	4.0
Periprosthetic fracture	4.6	0.2	2.2
Revision after knee removal	3.5	0.3	1.3
Insert wear	0.3	1.5	1.0
Loosening of patella component	0.6	0.8	0.7
Progression of osteoarthritis	0.2	0.7	0.5
Other	6.8	9.8	8.7

¹ 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.
² Only insert and/or patella exchange (including DAIR procedures).
³ Any type of revision includes all first revisions, including revision procedures that could not be classified as minor or major revision.
4 One patient may have more than one reason for revision. As such, the total proportion is over 100%.

Knee » Survival TKA» Revision within 1 and 3 years » Time after primary TKA

TABLE Time after primary total knee arthroplasty until short-term revision in the Netherlands in 2015-2019 (n=125,934)

Time after primary TKA	Percentage revisions (%)
Day 0-29	0.3
Day 30-182	0.4
Day 183-364	0.5
Day 365-730 (second year)	1.4
Day 731-1095 (third year)	0.8

TKA: total knee arthroplasty.

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