Total joint arthroplasty followup will become an increasingly important issue as the numbers of arthroplasty patients rise. The predictors of return for routine 1- and 2-year followup are not known. A retrospective review of 290 total knee arthroplasty patients was performed. Hospital operative records and clinical notes were used to determine demographic indicators and clinical followup compliance. Patient followup compliance decreased over time [6 months (82%), 1 year (78%), 2 year (37%)]. Using a logistic model, attendance at 6-month followup was found to be a significant positive predictor for 1-year followup. Using a multivariate model, obesity was found to be a negative predictor for 2-year followup, and compliance with 6-month and 1-year followup was found to be a positive predictor for 2-year followup. The data shows that current patient-dependent followup protocols are ineffective beyond one year, with only 37% of patients returning for their 2-year visit. Inclusion of a 6-month visit may improve 1-year followup, but 2-year followup remained low.