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Selected Instructional Course Lecture   |    
Revision Total Knee Arthroplasty: What the Practicing Orthopaedic Surgeon Needs to Know
David J. Jacofsky, MD1; Craig J. Della Valle, MD2; R. Michael Meneghini, MD3; Scott M. Sporer, MD4; Robert M. Cercek, MD1
1 The Core Institute, 3010 West Agua Fria Freeway, Suite 100, Phoenix, AZ 85027. E-mail address for D.J. Jacofsky: david.jacofsky@thecoreinstitute.com
2 Rush University Medical Center, 1611 West Harrison Street, Suite 300, Chicago, IL 60612
3 University of Connecticut Health Center, MARB 4th Floor, 263 Farmington Avenue, Farmington, CT 06034
4 1040 Golf Lane, Wheaton, IL 60189
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 (Smith and Nephew, Stryker, and Zimmer) and less than $10,000 (Biomet, Kinamed, and Angiotech) or a commitment or agreement to provide such benefits from these commercial entities.

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2011 in Instructional Course Lectures, Volume 60. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 May 01;92(5):1282-1292
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Extract

Total knee arthroplasties are done commonly, and the overall results are excellent, with 95% of the implants surviving for at least fifteen years1,2. The 5% that fail represent a substantial number, and orthopaedic surgeons are seeing an increasing number of patients who initially had a successful total knee replacement but then had pain, radiographic evidence of failure, and/or dysfunction due to failure of the arthroplasty. Extensive bone loss, instability, infection, dysfunction of the extensor mechanism, and periarticular arthrofibrosis are frequent challenges encountered during revision surgery. A systematic approach to the evaluation of patients requiring revision total knee arthroplasty can help identify the correct diagnosis and guide the surgical intervention, thereby optimizing success.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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