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Mid- and long-term revision
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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..
© LROI 2023
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)
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..
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023
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.
© LROI 2023