Why total knees fail-A modern perspective review

Table 1 Clinical studies by failure mechanism (%)

Ref.	Knees	Loosening	Infection	Instability	Malalignment	Poly/Lysis	Other
Rand et al[3]	227	34.9	0.2	16.7	14.8	-	5
Moreland et al[4]		MC		2nd MC
Fehring et al[5]	279	3%	38	26	5	7	5
Sharkey et al[6]	212	17/34	25/7.8	21/22	12/12	12/44
Mulhall et al[7]	318	41	25/7	29	9	6/25
Hossain et al[8]	349	3/12	12/21	4/3	4/3	1/12
Schroer et al[9] and Lombardi et al[10]	844	19/31	23/16	25/19	8/7	1/10	2/1
Sharkey et al[11]	781	22/40	38/28	12/8	3/2	2/4
Delanois et al[13]	337597	20.3	20.4	7.5		2.6	12
Kasahara et al[18]	147	40	24	9		9	18
Koh et al[19]	634	33	38	7	1	15	8

Overall percentages listed above may be approximates. Percentages may not be mutually exclusive[6,8-10]. Sharkey et al[6] table: First number is early (< 2 year) failures, second number is late failures; Hossain et al[8]: First number is early (< 2 year) failures, second is late failures; Schroer and Lombardi et al[9-10]: First number is early (< 2 year) failures, second is overall failures.

Table 2 Large data and registry data by total knee arthroplasty failure mechanism

Ref.	Knees	Loosening, %	Infection, %	Instability, %	Poly/Lysis, %	Other, %
Bozic et al[12]	60435	16	25	7	8
Delanois et al[13]	337597	20.3	20.4	7.5	2.6	12
Sadoghi et al[23]	36307	30	15	6	8
Australia 2003-2012[24]	31698	30	22	6	2
England/Wales 2011-2012[25]	5135	35	23	14	20
New Zealand 1999-2011[26]	4603	37	24	7	n/a
Norway 1994-2009[27]	3445	24	13	10	5
Sweden 2001-2010[28]	3375	26	23	13	5

Overall percentages are listed above.