Investigators may have uncovered which patients may be at high risk for revision total knee arthroplasty, according to a study published by Bounajem et al in the Archives of Orthopaedic and Trauma Surgery. The number of revision procedures taking place in the United States is predicted to increase by 78% to 182% from 2014 to 2030, costing the health-care system over $13 billion. The investigators used the State Inpatient Databases to identify 958,944 patients who underwent total knee arthroplasty between 2006 and 2015. Among the patients, 3.5% (n = 33,550) of them underwent revision procedures. Younger age was the most significant risk factor for revision—followed by male sex, Black race, hospital stays shorter or longer than 3 days, Elixhauser readmission scores, urban or rural residence, and indication for initial total knee arthroplasty other than primary osteoarthritis. Further, the risk of revision total knee arthroplasty associated with age was modified by an interaction with indication for total knee arthroplasty; for instance, as patients with osteoarthritis aged, they experienced a slower decline in their risk of revision compared with the linear reduction in risk experienced in other patients. Conversely, there were no statistically significant interactions between both sex and race risk factors and indication for total knee arthroplasty. The investigators hope their new findings can lead to improved risk stratification and patient awareness prior to total knee arthroplasty. In a companion press release on the findings from UT Southwestern Medical Center, the study authors concluded: “Revision rates are relatively low overall, but further research is needed into additional risk factor interactions due to the significant physical, psychological, and financial toll of revision surgery.”