Causes of failure and etiology of painful primary total knee arthroplasty

Romain Seil*, Dietrich Pape

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

81 Citations (Scopus)


The review provides an overview of the causes of failure and the many different aetiologies of a painful primary total knee arthroplasty (TKA). They can be classified into extra- and intraarticular disorders, the latter being divided into biological and mechanical origins. Whereas biological aetiologies like infections have remained stable over time, other causes of failure have changed. In the early times of knee arthroplasty, they were mainly related to technical insufficiencies. A better understanding of knee arthroplasty, patients' increasing functional demands as well as a continuous development of TKA techniques generated newer problems, which are increasingly related to the functioning of the soft-tissue envelope of the knee. From a therapeutic point of view, three situations can be considered: functional problems not needing reoperations, causes of reoperations not needing an exchange of prosthetic components as well as reoperations with exchange of at least one prosthetic component. Level of evidence IV.

Original languageEnglish
Pages (from-to)1418-1432
Number of pages15
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number9
Publication statusPublished - Sept 2011
Externally publishedYes


  • Complication
  • Instability
  • Loosening
  • Pain
  • Patellofemoral
  • Total knee arthroplasty


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