re-revision total knee arthroplasty: causes, risk factors and results

The rate of re-revision total knee arthroplasty (tka) ranges between 4% and 10%, depending on the cause of the procedure. periprosthetic joint infection (pji) and periprosthetic fracture are the main causes of re-revision tka. the likelihood of implant survival of re-revision tka diminishes with each subsequent revision, with pji being the main cause of multiple revisions. acute early asep tic revision tka (within 90 days of surgery) involves a high risk of re-revision at 2 years and a high risk of subsequent pji. the use of antibiotic-loaded cement is associated with lower risk of re-revision. patients younger than 50 years experiencing aseptic revision tka have a 1 in 3 risk of re-revision. patients revised for instability or having prior tka revisions have the highest risk of re -revision at 10 years. patients younger than 55 years experiencing revision tka have a 5 -year revision-free survival of 80%.