Revision per component

Cemented primary TKA – overall revision
Uncemented primary TKA – overall revision
Cemented primary TKA – major revision
Uncemented primary TKA – major revision
Bone cement
TKA by ODEP 5A or higher
TKA by type of femur

Knee » Survival TKA » Revision per component » Cemented primary TKA – overall revision

TABLE Cumulative revision percentages of cemented primary total knee arthroplasties by prosthesis component combination of patients who underwent a TKA for osteoarthritis in the Netherlands in 2007-2021 (n=249,091)

					Type of revision (n)						Cumulative revision percentage Kaplan Meier (95% CI)
Femur component	Tibia component	Total primary TKAs (n)	Median (IQR) age (yr)	Total RAs (n)	Total knee (complete revision)	Patella addition	Only femur component	Only tibia component	Only insert/ patella	Missing/ unknown	1yr	3yr	5yr	7yr	10yr	13yr
All cemented TKAs for osteoarthritis		249,091	69 (63-76)	10,967	3,839	2,116	465	1,000	3,279	268	0.9 (0.9-0.9)	3.2 (3.1-3.3)	4.2 (4.1-4.3)	4.9 (4.8-5.0)	5.7 (5.6-5.8)	6.4 (6.3-6.6)
Genesis II	Genesis II	58,842	69 (63-75)	2,809	677	620	225	201	881	70	1.2 (1.1-1.2)	3.9 (3.7-4.1)	5.0 (4.8-5.2)	5.6 (5.4-5.8)	6.3 (6.0-6.5)	6.8 (6.5-7.1)
NexGen	NexGen	55,960	69 (63-75)	2,326	948	252	70	289	652	60	0.9 (0.8-1.0)	2.8 (2.7-2.9)	3.9 (3.7-4.0)	4.8 (4.6-5.0)	5.9 (5.6-6.1)	6.9 (6.5-7.2)
Vanguard Complete Knee	Vanguard Complete Knee	44,620	69 (62-75)	1,583	543	300	39	129	473	40	0.9 (0.8-1.0)	2.9 (2.7-3.1)	3.7 (3.5-3.9)	4.2 (4.0-4.4)	4.9 (4.6-5.2)	5.3 (5.0-5.7)
PFC / SIGMA	PFC / SIGMA	30,254	70 (63-76)	1,137	345	265	29	86	354	26	0.9 (0.8-1.0)	3.0 (2.8-3.2)	3.8 (3.5-4.0)	4.1 (3.9-4.4)	4.6 (4.3-4.9)	4.9 (4.6-5.2)
LCS	LCS	17,243	70 (63-76)	735	379	73	34	140	91	11	0.6 (0.5-0.7)	3.1 (2.9-3.4)	4.2 (3.8-4.5)	4.7 (4.4-5.1)	5.3 (4.9-5.7)	6.0 (5.4-6.5)
Triathlon	Triathlon	8,852	70 (64-76)	305	93	51	13	27	86	4	1.2 (0.9-1.4)	3.6 (3.1-4.0)	4.5 (3.9-5.0)	5.1 (4.5-5.7)	5.7 (4.9-6.5)	n.a.
AGC V2	AGC V2	4,420*	71 (65-77)	171	99	54	1	2	10	5	0.3 (0.1-0.5)	2.0 (1.6-2.4)	2.6 (2.1-3.1)	3.2 (2.6-3.7)	3.8 (3.2-4.4)	4.7 (4.0-5.5)
balanSys	balanSys	3,642	69 (62-76)	167	59	64	3	8	23	3	0.7 (0.4-1.0)	3.7 (3.0-4.4)	5.0 (4.2-5.8)	5.9 (4.9-6.8)	6.7 (5.6-7.9)	7.9 (6.3-9.5)
TC Plus	TC Plus	3,456	70 (63-76)	108	57	28	2	5	12	4	0.6 (0.3-0.8)	2.3 (1.8-2.8)	3.0 (2.3-3.6)	3.3 (2.7-4.0)	4.2 (3.3-5.1)	4.5 (3.5-5.5)
Attune	Attune	3,261	69 (61-75)	48	10	12	3	10	20	1	0.5 (0.2-0.8)	2.4 (1.7-3.2)	3.2 (2.2-4.1)	n.a.	n.a.	n.a.
Optetrak	Optetrak	3,073*	70 (62-76)	348	196	90	3	33	55	6	1.1 (0.7-1.4)	5.3 (4.5-6.1)	7.1 (6.2-8.0)	9.1 (8.1-10.2)	12.0 (10.8-13.3)	15.3 (13.4-17.2)
Persona	Persona	2,909	68 (62-74)	35	9	4	0	3	29	0	0.6 (0.3-1.0)	3.8 (2.0-5.5)	5.3 (3.1-7.6)	5.9 (3.4-8.3)	n.a.	n.a.
ACS	ACS	2,673	67 (60-73)	139	34	21	9	12	18	8	0.7 (0.4-1.0)	3.8 (3.1-4.5)	4.8 (4.0-5.6)	5.1 (4.2-5.9)	5.5 (4.6-6.5)	n.a.
Scorpio NRG	Scorpio	2,631*	70 (63-76)	137	48	45	10	4	8	1	0.8 (0.5-1.2)	3.2 (2.5-3.8)	4.5 (3.7-5.3)	5.1 (4.3-6.0)	5.7 (4.8-6.7)	n.a.
Scorpio	Scorpio	2,240*	71 (63-76)	114	60	22	3	6	39	4	0.3 (0.1-0.5)	2.4 (1.7-3.0)	3.2 (2.5-3.9)	3.7 (2.9-4.5)	4.7 (3.8-5.6)	5.8 (4.7-6.9)
Journey BCS	Journey BCS	1,362	69 (61-74)	127	17	62	1	3	9	2	1.1 (0.5-1.6)	5.5 (4.2-6.8)	6.8 (5.4-8.3)	8.7 (7.0-10.4)	10.8 (8.8-12.7)	13.9 (11.2-16.5)
MRK	MRK	1,321	69 (62-75)	22	10	7	0	0	7	1	0.2 (0.0-0.4)	1.4 (0.6-2.1)	2.2 (1.2-3.2)	3.2 (1.8-4.7)	n.a.	n.a.
PFC / SIGMA	LCS	1,212*	66 (58-75)	54	27	11	3	1	2	2	0.3 (0.0-0.7)	1.9 (1.1-2.7)	2.9 (1.9-3.9)	3.9 (2.8-5.1)	4.7 (3.4-6.0)	5.7 (4.1-7.3)
NexGen GSF	NexGen	1,190	68 (61-74)	32	18	5	0	1	19	1	0.5 (0.1-0.9)	1.6 (0.9-2.3)	2.6 (1.7-3.6)	2.9 (1.9-3.9)	3.3 (2.1-4.5)	n.a.
Innex	Innex	1,126*	70 (62-77)	38	13	10	0	4	10	0	1.0 (0.4-1.6)	2.2 (1.3-3.0)	2.8 (1.8-3.8)	3.2 (2.2-4.3)	3.5 (2.4-4.6)	3.6 (2.5-4.8)
Journey II BCS	Journey BCS	1,072	66 (60-72)	64	13	26	0	0	6	2	0.4 (0.0-0.8)	4.5 (3.2-5.8)	6.1 (4.6-7.6)	7.1 (5.3-8.9)	n.a.	n.a.
Evolution MP	Evolution MP	837	69 (63-74)	18	5	5	0	0	9	1	0.6 (0.1-1.2)	2.3 (1.1-3.5)	3.4 (1.6-5.2)	n.a.	n.a.	n.a.
Profix	Profix	772*	68 (61-76)	59	40	7	2	2	5	1	0.5 (0.0-1.0)	3.7 (2.3-5.0)	5.6 (3.9-7.2)	6.6 (4.8-8.3)	7.7 (5.8-9.7)	8.9 (6.4-11.4)
Genesis II	Profix / Genesis MB baseplate	622*	67 (60-75)	66	27	30	0	1	7	1	1.0 (0.2-1.8)	6.9 (4.9-8.9)	9.0 (6.7-11.3)	10.3 (7.8-12.7)	11.3 (8.7-13.8)	11.3 (8.7-13.8)
Rotaglide	Rotaglide	428*	72 (65-78)	40	26	3	2	0	7	0	0.9 (0.0-1.9)	4.5 (2.5-6.5)	5.9 (3.7-8.2)	7.2 (4.7-9.6)	10.4 (7.3-13.5)	n.a.
Advance MP	Advance	314*	71 (65-78)	31	6	6	1	5	10	3	1.9 (0.4-3.4)	7.7 (4.7-10.6)	9.0 (5.8-12.1)	9.3 (6.1-12.5)	9.7 (6.4-12.9)	n.a.
Maxim	Vanguard Complete Knee	272*	70 (63-77)	14	3	3	1	2	5	0	1.5 (0.0-2.9)	2.9 (0.9-4.9)	3.3 (1.2-5.4)	4.1 (1.7-6.4)	4.8 (2.3-7.4)	5.2 (2.6-7.8)

* Denotes prosthesis combinations with no reported use in primary TKAs in 2021.
Please note: n.a. if <50 cases were at risk; TKA: total knee arthroplasty; RA: revision arthroplasty; CI: confidence interval; IQR: interquartile range.

Only combinations with over 250 procedures have been listed.
Results must be interpreted with caution. Patient characteristics like age and diagnosis, as well as procedure characteristics like the experience of the surgeon performing the procedure of the prosthesis may have influenced the cumulative revision percentages.

Knee » Survival TKA » Revision per component » Uncemented primary TKA – overall revision

TABLE Cumulative revision percentages of uncemented primary total knee arthroplasties by prosthesis component combination of patients who underwent a TKA for osteoarthritis in the Netherlands in 2007-2021 (n=13,002)

					Type of revision (n)						Cumulative revision percentage Kaplan Meier (95% CI)
Femur component	Tibia component	Total primary TKAs (n)	Median (IQR) age (yr)	Total RAs (n)	Total knee (complete revision)	Patella addition	Only femur component	Only tibia component	Only insert/ patella	Missing/ unknown	1yr	3yr	5yr	7yr	10yr	13yr
All uncemented TKAs for osteoarthritis		13,002	69 (62-76)	606	215	89	12	113	170	7	1.0 (0.8-1.2)	3.7 (3.3-4.0)	4.6 (4.2-5.0)	5.1 (4.6-5.5)	5.7 (5.2-6.2)	6.3 (5.8-6.9)
LCS	LCS	8,756	69 (63-76)	387	109	44	9	90	110	4	0.9 (0.7-1.1)	3.5 (3.1-3.9)	4.2 (3.7-4.6)	4.5 (4.1-5.0)	5.1 (4.5-5.6)	5.6 (4.9-6.2)
Triathlon	Triathlon	1,648	69 (62-75)	33	11	6	0	2	10	0	0.5 (0.1-0.8)	1.7 (0.9-2.4)	2.4 (1.5-3.4)	3.0 (1.9-4.2)	3.4 (2.0-4.8)	n.a.
ACS	ACS	593	69 (61-75)	30	11	6	1	4	5	0	2.2 (1.0-3.4)	4.9 (3.0-6.7)	5.4 (3.4-7.3)	5.7 (3.6-7.8)	n.a.	n.a.
Duracon	Duracon	296*	69 (61-77)	10	4	1	0	0	4	0	0.4 (0.0-1.0)	0.7 (0.0-1.7)	1.4 (0.0-2.8)	1.4 (0.0-2.8)	3.1 (1.0-5.1)	3.5 (1.2-5.7)
Attune	Attune	269	68 (62-73)	10	2	2	0	0	7	0	2.2 (0.3-4.1)	7.3 (2.6-12.1)	n.a.	n.a.	n.a.	n.a.
Rotaglide	Rotaglide	271*	69 (61-77)	61	38	11	1	1	5	1	1.5 (0.0-3.0)	10.3 (6.6-14.0)	16.3 (11.8-20.8)	19.8 (14.8-24.7)	21.8 (16.6-27.1)	n.a.
ACS LD	ACS LD	249*	70 (61-76)	16	6	3	0	1	3	0	1.3 (0.0-2.8)	5.7 (2.7-8.7)	5.7 (2.7-8.7)	n.a.	n.a.	n.a.
NexGen	NexGen	230	69 (62-77)	17	7	1	1	3	1	0	1.8 (0.1-3.5)	5.0 (2.1-7.9)	7.2 (3.4-10.9)	8.1 (4.0-12.3)	9.3 (4.6-14.0)	n.a.
Genesis II	Genesis II	225	68 (62-75)	11	5	2	0	1	1	1	1.0 (0.0-2.3)	5.2 (2.1-8.4)	5.2 (2.1-8.4)	5.2 (2.1-8.4)	5.2 (2.1-8.4)	n.a.
Vanguard Complete Knee	Vanguard Complete Knee	165*	67 (61-74)	13	6	1	0	4	4	0	2.6 (0.1-5.0)	5.8 (2.1-9.5)	5.8 (2.1-9.5)	7.0 (2.7-11.3)	n.a.	n.a.

Only combinations with over 100 procedures have been listed.
Results must be interpreted with caution. Patient characteristics like age and diagnosis, as well as procedure characteristics like the experience of the surgeon performing the procedure of the prosthesis may have influenced the cumulative revision percentages.

Knee » Survival TKA » Revision per component » Cemented primary TKA – major revision

TABLE Cumulative major revision percentages of cemented primary total knee arthroplasties by prosthesis component combination of patients who underwent a TKA for osteoarthritis in the Netherlands in 2007-2021 (n=249,091)

					Cumulative revision percentage Kaplan Meier (95% CI)
Femur component	Tibia component	Total primary TKAs (n)	Median (IQR) age (yr)	Major revision¹ arthroplasties (n)	1yr	3yr	5yr	7yr	10yr	13yr
All cemented TKAs for osteoarthritis		249,091	69 (63-76)	5,903	0.3 (0.3-0.4)	1.6 (1.5-1.6)	2.2 (2.1-2.2)	2.6 (2.6-2.7)	3.2 (3.1-3.3)	3.8 (3.7-3.9)
Genesis II	Genesis II	58,842	69 (63-75)	1,251	0.4 (0.3-0.4)	1.7 (1.5-1.8)	2.2 (2.1-2.4)	2.6 (2.4-2.7)	2.9 (2.8-3.1)	3.2 (3.0-3.4)
NexGen	NexGen	55,960	69 (63-75)	1,430	0.3 (0.3-0.4)	1.5 (1.3-1.6)	2.2 (2.0-2.3)	3.0 (2.8-3.1)	3.9 (3.7-4.2)	4.8 (4.4-5.1)
Vanguard Complete Knee	Vanguard Complete Knee	44,620	69 (62-75)	814	0.4 (0.3-0.4)	1.4 (1.3-1.5)	1.9 (1.7-2.0)	2.2 (2.0-2.4)	2.6 (2.4-2.8)	2.9 (2.6-3.2)
PFC / SIGMA	PFC / SIGMA	30,254	70 (63-76)	521	0.3 (0.2-0.4)	1.2 (1.1-1.3)	1.7 (1.5-1.8)	1.9 (1.7-2.1)	2.2 (2.0-2.4)	2.4 (2.1-2.6)
LCS	LCS	17,243	70 (63-76)	584	0.4 (0.3-0.5)	2.3 (2.1-2.6)	3.2 (2.9-3.5)	3.8 (3.5-4.1)	4.4 (4.0-4.8)	5.0 (4.5-5.5)
Triathlon	Triathlon	8,852	70 (64-76)	148	0.4 (0.3-0.6)	1.7 (1.4-2.0)	2.3 (1.9-2.7)	2.7 (2.2-3.1)	2.9 (2.4-3.5)	n.a.
AGC V2	AGC V2	4,420*	71 (65-77)	109	0.1 (0.0-0.2)	1.1 (0.8-1.4)	1.5 (1.1-1.9)	1.9 (1.5-2.3)	2.4 (1.9-2.9)	3.1 (2.5-3.7)
balanSys	balanSys	3,642	69 (62-76)	76	0.2 (0.1-0.3)	1.4 (1.0-1.8)	2.3 (1.8-2.9)	2.9 (2.2-3.6)	3.2 (2.4-3.9)	3.8 (2.6-4.9)
TC Plus	TC Plus	3,456	70 (63-76)	71	0.4 (0.2-0.6)	1.4 (1.0-1.8)	2.0 (1.5-2.5)	2.4 (1.8-2.9)	2.6 (2.0-3.3)	3.1 (2.2-4.1)
Attune	Attune	3,261	69 (61-75)	24	0.2 (0.0-0.4)	1.2 (0.6-1.7)	1.7 (0.9-2.3)	n.a.	n.a.	n.a.

¹ Revision of at least the femur or tibia component.
* Denotes prosthesis combinations with no reported use in primary TKAs in 2021.
Please note: n.a. if <50 cases were at risk; TKA: total knee arthroplasty; CI: confidence interval; IQR: interquartile range.

Results must be interpreted with caution. Patient characteristics like age and diagnosis, as well as procedure characteristics like the experience of the surgeon performing the procedure of the prosthesis may have influenced the cumulative revision percentages.

Knee » Survival TKA » Revision per component » Uncemented primary TKA – major revision

TABLE Cumulative major revision percentages of uncemented primary total knee arthroplasties by prosthesis component combination of patients who underwent a TKA for osteoarthritis in the Netherlands in 2007-2021 (n=13,002)

					Cumulative revision percentage Kaplan Meier (95% CI)
Femur component	Tibia component	Total primary TKAs (n)	Median (IQR) age (yr)	Major revision¹ arthroplasties (n)	1yr	3yr	5yr	7yr	10yr	13yr
All uncemented TKAs for osteoarthritis		13,002	69 (62-75)	372	0.6 (0.4-0.7)	2.2 (1.8-2.5)	2.7 (2.3-3.0)	2.8 (2.4-3.2)	3.0 (2.6-3.4)	3.3 (2.8-3.8)
LCS	LCS	8,446	69 (63-76)	225	0.6 (0.4-0.7)	2.2 (1.8-2.5)	2.7 (2.3-3.0)	2.8 (2.4-3.2)	3.0 (2.6-3.4)	3.3 (2.8-3.8)
Triathlon	Triathlon	1,56	69 (62-75)	16	0.3 (0.0-0.6)	0.7 (0.2-1.1)	1.2 (0.5-1.9)	1.6 (0.7-2.5)	2.5 (1.0-4.0)	n.a.
ACS	ACS	573	69 (61-75)	18	1.6 (0.6-2.7)	3.1 (1.6-4.6)	3.4 (1.8-4.9)	3.7 (2.0-5.4)	n.a.	n.a.
Duracon	Duracon	282*	69 (61-77)	4	0.0 (0.0-0.0)	0.0 (0.0-0.0)	0.4 (0.0-1.1)	0.4 (0.0-1.1)	1.6 (0.0-3.1)	1.6 (0.0-3.1)
Attune	Attune	266	68 (62-73)	2	0.4 (0.0-1.2)	1.5 (0.0-3.6)	n.a.	n.a.	n.a.	n.a.
Rotaglide	Rotaglide	265*	69 (61-77)	45	0.4 (0.0-1.1)	6.5 (3.5-9.5)	11.3 (7.4-15.2)	15.2 (10.7-19.6)	17.3 (12.5-22.1)	n.a.
ACS LD	ACS LD	234*	70 (61-76)	8	1.3 (0.0-2.8)	3.5 (1.1-5.9)	3.5 (1.1-5.9)	n.a.	n.a.	n.a.
NexGen	NexGen	228	69 (62-77)	12	1.3 (0.0-2.8)	3.7 (1.2-6.2)	5.0 (1.9-8.0)	5.9 (2.4-9.5)	5.9 (2.4-9.5)	n.a.
Genesis II	Genesis II	215	68 (62-75)	6	0.5 (0.0-1.4)	3.2 (0.7-5.6)	3.2 (0.7-5.6)	3.2 (0.7-5.6)	3.2 (0.7-5.6)	n.a.
Vanguard Complete Knee	Vanguard Complete Knee	157*	67 (61-74)	10	1.9 (0.0-4.0)	4.5 (1.2-7.8)	4.5 (1.2-7.8)	5.7 (1.7-9.7)	n.a.	n.a.

Results must be interpreted with caution. Patient characteristics like age and diagnosis, as well as procedure characteristics like the experience of the surgeon performing the procedure of the prosthesis may have influenced the cumulative revision percentages.

Knee » Survival TKA » Revision per component » Bone cement

TABLE Cumulative revision percentages of the most frequently registered types of bone cement by type of mixing system in primary total knee arthroplasties in the Netherlands in 2007-2021

			Cumulative revision percentage Kaplan Meier (95% CI)
Bone cement	Total primary TKAs (n)	Total RAs (n)	1yr	3yr	5yr	7yr	10yr	13yr
Separately packed bone cement components	178,368	8,374	0.9 (0.9-0.9)	3.3 (3.2-3.4)	4.3 (4.2-4.4)	5.0 (4.9-5.1)	5.8 (5.7-6.0)	6.5 (6.4-6.7)
Palacos R+G	132,927	6,149	0.9 (0.9-1.0)	3.3 (3.2-3.4)	4.3 (4.2-4.4)	5.0 (4.9-5.1)	5.8 (5.7-6.0)	6.5 (6.3-6.8)
Refobacin Bone Cement R	12,700	610	0.8 (0.6-0.9)	3.0 (2.7-3.3)	4.0 (3.6-4.4)	5.1 (4.7-5.6)	6.4 (5.9-7.0)	7.4 (6.7-8.1)
Palacos MV+G	8,162	356	0.8 (0.6-1.0)	3.1 (2.7-3.4)	4.1 (3.6-4.5)	4.8 (4.3-5.3)	5.2 (4.6-5.7)	n.a.
Simplex ABC EC	5,368*	349	1.0 (0.8-1.3)	3.9 (3.4-4.4)	5.2 (4.6-5.8)	6.2 (5.6-6.9)	7.2 (6.5-8.0)	n.a.
Simplex ABC Tobra	5,121	219	0.8 (0.5-1.0)	2.2 (1.8-2.6)	3.0 (2.6-3.5)	3.6 (3.1-4.2)	4.7 (4.0-5.4)	5.8 (4.7-6.9)
Refobacin Plus Bone Cement	3,155*	197	1.1 (0.7-1.4)	4.3 (3.6-5.1)	5.4 (4.6-6.2)	5.9 (5.1-6.7)	6.4 (5.5-7.3)	6.8 (5.9-7.8)
Palacos R	1,751*	778	0.6 (0.2-0.9)	2.6 (1.8-3.4)	3.3 (2.4-4.1)	3.9 (3.0-4.8)	4.6 (3.6-5.6)	5.2 (3.9-6.5)
Biomet Plus Bone Cement	1,472	64	1.0 (0.5-1.5)	3.5 (2.6-4.5)	4.5 (3.4-5.6)	4.8 (3.6-6.0)	5.2 (3.9-6.5)	n.a.
Palamed G	1,429*	57	0.2 (0.0-0.4)	2.3 (1.5-3.0)	3.1 (2.2-4.1)	3.5 (2.6-4.5)	4.0 (3.0-5.0)	4.2 (3.1-5.2)
Subiton G	1,161	34	1.0 (0.4-1.5)	5.3 (3.2-7.4)	n.a.	n.a.	n.a.	n.a.
Versabond	647*	50	0.6 (0.0-1.2)	5.3 (3.6-7.0)	6.3 (4.4-8.1)	6.8 (4.8-8.7)	7.3 (5.3-9.4)	n.a.
cemSys 1G	636*	43	1.4 (0.5-2.3)	3.8 (2.3-5.3)	6.3 (4.4-8.2)	7.4 (5.1-9.6)	n.a.	n.a.
Biomet Bone Cement R	598	20	0.9 (0.0-1.7)	4.7 (2.3-7.2)	6.3 (3.1-9.6)	7.3 (3.5-11.0)	7.3 (3.5-11)	n.a.
Simplex P	409*	21*	0.0 (0.0-0.0)	2.8 (1.2-4.4)	3.8 (1.9-5.7)	4.4 (2.3-6.4)	5.3 (3-7.5)	5.6 (3.3-8.0)
Simplex HV	382	8	0.8 (0.0-1.7)	2.5 (0.4-4.5)	3.7 (0.5-6.8)	n.a.	n.a.	n.a.
Synicem1G	339*	12	0.6 (0.0-1.4)	3.6 (1.6-5.6)	n.a.	n.a.	n.a.	n.a.
Palamed	250*	14	0.8 (0.0-1.9)	2.8 (0.8-4.8)	4.0 (1.6-6.4)	4.9 (2.2-7.5)	5.3 (2.5-8.1)	5.3 (2.5-8.1)
Bone cement pre-packed in a vacuum mixing system	79,886	2,658	1.0 (0.9-1.1)	3.3 (3.2-3.5)	4.2 (4.0-4.3)	4.8 (4.6-5.0)	5.5 (5.2-5.8)	6.4 (5.8-6.9)
Refobacin Bone Cement R	35,885	1,206	1.1 (1.0-1.2)	3.3 (3.0-3.5)	4.2 (3.9-4.5)	5.0 (4.6-5.3)	5.6 (5.2-6.0)	n.a.
Palacos R+G	26,935	723	1.1 (1.0-1.2)	3.4 (3.1-3.7)	4.1 (3.8-4.4)	4.5 (4.1-5.0)	n.a.	n.a.
Refobacin Plus Bone Cement	15,254	620	0.7 (0.6-0.9)	3.2 (2.9-3.5)	4.0 (3.6-4.3)	4.5 (4.1-4.9)	5.2 (4.7-5.6)	6.0 (5.2-6.7)
Cemex Genta	1,444*	95	1.0 (0.5-1.6)	4.9 (3.8-6.0)	5.6 (4.4-6.8)	6.3 (5.0-7.6)	7.0 (5.6-8.5)	n.a.

* Denotes types of bone cement with no reported use in primary TKAs in 2021.
Please note: n.a. if <50 cases were at risk; TKA: total knee arthroplasty; RA: revision arthroplasy; CI: confidence interval; IQR: interquartile range.

Only types of bone cement with over 250 procedures have been listed.
Results must be interpreted with caution. Patient characteristics like age and diagnosis, as well as procedure characteristics like the experience of the surgeon performing the procedure of the prosthesis may have influenced the cumulative revision percentages.

ODEP rating
Orthopaedic Data Evaluation Panel. ODEP provides ratings for hip femoral stems, hip acetabular cups and total knee replacement implants. An ODEP rating consists of a number and a letter (A or B), and a star (optional). The number represents the number of years for which the product’s performance had been evidenced. The letter represents the strength of evidence presented by the manufacturer (A represents strong evidence and B represents acceptable evidence). A Star (*) represents very strong evidence above A and B. Detailed information can be found at www.odep.org.uk

Knee » Survival TKA » Revision per component » TKA by ODEP 5A or higher

FIGURE Cumulative major revision percentage of total knee arthroplasties by ODEP classification 5A or higher in the Netherlands in 2007-2021 (n= 289,912)

TABLE Cumulative 13-year revision percentage

		Cumulative 13-year major revision percentage
	Number (n)	Competing Risk¹ (95% CI)	Kaplan Meier (95% CI)
ODEP
<5A	40,785	4.2 (3.9-4.4)	4.6 (4.3-4.9)
5A or higher	249,127	3.3 (3.2-3.4)	3.6 (3.5-3.7)

¹ The cumulative revision percentage using the competing risk method is shown in the figure.
Major revision percentage: 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.
ODEP rating: ODEP provides ratings for hip femoral stems, hip acetabular cups and total knee replacement implants. Detailed information can be found at www.odep.org.uk.
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 » Revision per component » TKA by type of femur

FIGURE Cumulative major revision percentage of total knee arthroplasties by prosthesis design in the Netherlands in 2007-2021 (n=288,993)

TABLE Cumulative 13-year major revision percentage

		Cumulative 13-year major revision percentage
	Number (n)	Competing Risk¹ (95% CI)	Kaplan Meier (95% CI)
Prosthesis design
Posterior stabilised (PS)	150,765	4.0 (3.9-4.2)	4.4 (4.2-4.6)
Cruciate retaining (CR)	138,228	3.1 (3.0-3.3)	3.4 (3.2-3.5)

¹ The cumulative revision percentage using the competing risk method is shown in the figure.
Major revision percentage: 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; PS: posterior stabilised; CR: cruciate retaining; CI: confidence interval.

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