Revision knee arthroplasty for aseptic loosening: when do tibial implants fail and can distinct failure mechanisms be identified? – A retrospective study using Dutch Arthroplasty Register (LROI) data
Approval date: May 16th 2025
Starting date: June 19th 2025
SN van Laarhoven, PJC Heesterbeek, MR de Bondt
Research proposal abstract:
Aseptic loosening is the failure of implant fixation to the surrounding bone and one of the most frequent reasons for revision surgery. It impacts patients across the entire lifespan of a primary total knee arthroplasty (TKA). Therefore, understanding its mechanisms is essential to enhance orthopedic care, with potential benefits including improved surgical revision strategies, prevention of loosening, and enhanced data quality for research and implant registries.
This study involves a retrospective analysis of the Dutch Arthroplasty Register (LROI) database. All total primary knee implants registered in this database between 2007 and 2024 that underwent tibial component revision due to aseptic loosening will be included. Comprehensive data analysis, including cluster analysis, will explore patterns. As aseptic loosening can result from different underlying mechanisms (e.g. failure of primary fixation in uncemented TKA or failure due to polyethylene osteolysis), it is hypothesized that the time to failure is associated with these specific failure mechanisms.