Does implant selection affect outcome of revision knee arthroplasty?

We reviewed 139 consecutive femoral or tibial revision knee arthroplasties to determine if the outcome of revision knee arthroplasty using revision implant systems was superior to revisions using primary implant systems. Group 1 (n = 42) consisted of revisions performed with implants designed for primary total knee arthroplasty. Group 2 (n = 42) consisted of revisions performed with modified primary components. Group 3 (n = 55) consisted of revisions performed with components specifically designed for revision arthroplasty. The implant status was known in 123 of 139 knees at a mean follow-up of 7 years (range, 5-12 years). The implant-related failure rate, defined as reoperation requiring component revision or removal, was 26% for group 1, 14% for group 2, and 6% for group 3 (P<.05). Revision implants exhibited superior performance and durability despite their use in more difficult reconstructions. The improved longevity of revision implants justifies the evolution of modular revision components.