Evidence map›Paper›PMID 41235452›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

High early complication risk but low risk of re-revision beyond 5 years following revision knee arthroplasty in the elderly: An analysis of 2833 cases using real-world data from an international database.

Ben Tyas, Joseph Williams, Simon Jameson, David Deehan, Paul Baker

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ben TyasNational Joint Registry/Orthopaedic Research UK/Royal College of Surgeons of England, London, UK.ORCID https://orcid.org/0000-0002-7858-4988
Joseph WilliamsNorthumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK.
Simon JamesonSouth Tees Hospitals NHS Foundation Trust, Trauma & Orthopaedics, Middlesbrough, UK.
David DeehanNewcastle Hospitals NHS Foundation Trust, Trauma & Orthopaedics, Newcastle, UK.
Paul BakerSouth Tees Hospitals NHS Foundation Trust, Academic Centre for Surgery, Middlesbrough, UK.

Funding

Ben Tyas is jointly funded by the National Joint Registry, Orthopaedic Research UK and the Royal College of Surgeons of England on a 2-year research fellowship. The views expressed in this publication are those of the authors and not necessarily those of any funding body.
6 · The paper itself

Abstract

purposeWith an increasing global elderly population, the number of revision total knee arthroplasties (rTKAs) in patients aged ≥80 years is rising. However, outcomes in this age group remain difficult to report and poorly understood. This study aimed to evaluate clinical outcomes, 90-day complication rates and long-term implant survivorship after rTKA in patients aged ≥80 years, and to compare results between revisions for aseptic loosening and prosthetic joint infection (PJI).

methodsData were extracted from TriNetX, a global healthcare database covering 21 countries. Patients aged ≥80 years undergoing rTKA were included. Outcomes assessed included 90-day complications and mortality, crude re-revision rates at 2, 5 and 10 years, and implant and patient survivorship. Propensity score-matched analysis compared outcomes between aseptic loosening and PJI cohorts. Cox regression identified predictors of 90-day mortality and 2-year re-revision risk.

resultsA total of 2833 patients were included. Ninety-day mortality was 2.7%. Acute kidney injury (AKI) was the most frequent complication (9.9%), particularly among PJI patients (18.2%). Crude re-revision rates were 9.3%, 10.4% and 10.5% at 2, 5 and 10 years, respectively, while implant survivorship was 87.7%, 83.6% and 81.8%. Ten-year patient survivorship was 38.8%. Patients with PJI had higher comorbidity burdens and postoperative complication rates. After matching, PJI patients showed increased risk of 90-day mortality (relative risk [RR] = 2.00, p = 0.051) and AKI (RR = 1.91, p < 0.001). Cox regression confirmed PJI as an independent predictor of 90-day mortality (hazard ratio [HR] = 2.51, p = 0.008) and 2-year re-revision (HR = 1.70, p = 0.001).

conclusionsElderly patients undergoing rTKA for PJI exhibit greater comorbidity, higher complication rates and increased early mortality compared to those revised for aseptic loosening. Re-revision beyond 5 years is uncommon. In this population, outcomes such as mortality, mobility and quality of life may be more clinically meaningful than long-term implant survivorship. LEVEL OF EVIDENCE: Level IV.

Indexed as

Arthroplasty, Replacement, KneePostoperative ComplicationsProsthesis-Related InfectionsReoperationAged, 80 and overDatabases, FactualFemaleHumansKnee ProsthesisMaleProsthesis FailureRetrospective StudiesRisk FactorsTime Factorselderlyoctogenariansprosthetic joint infectionreoperationrevision knee arthroplasty

Identifiers

PMID41235452
PMCPMC13418284

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.