BACKGROUND AND PURPOSE Total knee replacement (TKR) studies usually analyze all-cause revision when considering relationships with patient and prosthesis factors. We studied how these factors impact different revision diagnoses. PATIENTS AND METHODS We used data from 2003 to 2019 of TKR for osteoarthritis from the arthroplasty registries of Sweden, Australia, and Kaiser Permanente, USA to study patient and prosthesis characteristics for specific revision diagnoses. There were 1,072,924 primary TKR included and 36,626 were revised. Factors studied included age, sex, prosthesis constraint, fixation method, bearing mobility, polyethylene type, and patellar component use. Revision diagnoses were arthrofibrosis, fracture, infection, instability, loosening, pain, patellar reasons, and wear. Odds ratios (ORs) for revision were estimated and summary effects were calculated using a meta-analytic approach. RESULTS We found between-registry consistency in 15 factor/reason analyses. Risk factors for revision for arthrofibrosis were age < 65 years (OR 2.0; 95% CI 1.4-2.7) and mobile bearing designs (MB) (OR 1.7; CI 1.1-2.5), for fracture were female sex (OR 3.2; CI 2.2-4.8), age ≥ 65 years (OR 2.8; CI 1.9-4) and posterior stabilized prostheses (PS) (OR 2.1; CI 1.3-3.5), for infection were male sex (OR 1.9; CI 1.7-2.0) and PS (OR 1.5; CI 1.2-1.8), for instability were age < 65 years (OR 1.5; CI 1.3-1.8) and MB (OR 1.5; CI 1.1-2.2), for loosening were PS (OR 1.5; CI 1.4-1.6), MB (OR 2.2; CI 1.6-3.0) and use of ultra-high molecular weight polyethylene (OR 2.3; CI 1.8-2.9), for patellar reasons were not resurfacing the patella (OR 13.6; CI 2.1-87.2) and MB (OR 2.0; CI 1.2-3.3) and for wear was cementless fixation (OR 4.9; CI 4.3-5.5). INTERPRETATION Patients could be counselled regarding specific age and sex risks. Use of minimally stabilized, fixed bearing, cemented prostheses, and patellar components is encouraged to minimize revision risk.

中文翻译：

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患者和假体特征对全膝关节置换翻修常见原因的影响：对来自澳大利亚、瑞典和美国的 36,626 例翻修病例进行的注册研究。

背景和目的 全膝关节置换 (TKR) 研究通常在考虑与患者和假体因素的关系时分析全因翻修。我们研究了这些因素如何影响不同的翻修诊断。患者和方法 我们使用瑞典、澳大利亚和美国 Kaiser Permanente 的关节置换登记处 2003 年至 2019 年 TKR 治疗骨关节炎的数据来研究特定翻修诊断的患者和假体特征。包含 1,072,924 个主要 TKR，修订了 36,626 个。研究的因素包括年龄、性别、假体约束、固定方法、轴承活动度、聚乙烯类型和髌骨组件的使用。修正诊断为关节纤维化、骨折、感染、不稳定、松动、疼痛、髌骨原因和磨损。估计修订的比值比 (OR) 并使用元分析方法计算汇总效应。结果 我们在 15 个因素/原因分析中发现了注册机构之间的一致性。关节纤维化翻修的危险因素是年龄 < 65 岁 (OR 2.0; 95% CI 1.4-2.7) 和移动轴承设计 (MB) (OR 1.7; CI 1.1-2.5)，骨折是女性 (OR 3.2; CI 2.2) -4.8），年龄≥65 岁（OR 2.8；CI 1.9-4）和后路稳定假体（PS）（OR 2.1；CI 1.3-3.5），感染为男性（OR 1.9；CI 1.7-2.0）和 PS (OR 1.5; CI 1.2-1.8)，不稳定的年龄 < 65 岁 (OR 1.5; CI 1.3-1.8) 和 MB (OR 1.5; CI 1.1-2.2)，松动的 PS (OR 1.5; CI 1.4-1.6 ), MB (OR 2.2; CI 1.6-3.0) 和使用超高分子量聚乙烯 (OR 2.3; CI 1.8-2.9), 因髌骨原因未进行髌骨表面置换术 (OR 13.6; CI 1.8-2.9) CI 2.1-87.2) 和 MB (OR 2.0; CI 1.2-3.3) 和磨损是非骨水泥固定 (OR 4.9; CI 4.3-5.5)。解释 可以就具体的年龄和性别风险向患者提供咨询。鼓励使用最低限度稳定的固定轴承、骨水泥假体和髌骨组件，以最大限度地降低翻修风险。