A 15-year follow-up study of 4606 primary total knee replacements

Abstract

This is a 15-year follow-up observational study of 4390 patients with 4606 primary total knee replacements (TKRs) implanted in the Trent health region between 1990 and 1992. The operations were performed in 21 hospitals, including both district general and teaching hospitals, with 77 different surgeons as named consultant. The main objective was to analyse the survival of the patients and of the prostheses, and to evaluate what impact different variables have on survival. In addition, the 1480 patients (33.7%) (1556 TKRs) alive at 15 years following operation were sent a self-administered questionnaire which examined their level of satisfaction, of pain, and their quality of life at 15 years. Completed responses were received from 912 TKRs (58.6%). Three survival curves were constructed: a best-case scenario based on the patients entered into the life tables, another included failures not reported in the revision database, and a third worst-case scenario based on all patients lost to follow-up presumed to have had a failed primary TKR. In the best-case scenario survival at 15 years was 92.2%, and in the worst-case scenario was 81.1%. Survival was significantly increased in women and older patients (Mantel-Cox log-rank test, p < 0.005 and p < 0.001, respectively). Revision as a result of infection was required in 40 TKRs (18.8%) representing 0.87% of the original cohort. The limited information available from the questionnaire indicated that satisfaction was less frequent among men, patients with osteoarthritis and those who required revision (chi-squared test, p < 0.05, p < 0.05 and p < 0.0001, respectively). With regard to pain, older patients, females and patients who still had their primary replacement in place at 15 years, reported the least pain (chi-squared test for trends, p < 0.0005, p < 0.005 and p < 0.0001, respectively). The reported quality of life was not affected by any variable.

All-Polyethylene Versus Metal-Backed Tibial Components—An Analysis of 27,733 Cruciate-Retaining Total Knee Replacements from the Swedish Knee Arthroplasty Register

“…However, men are at higher risk of revision due to infection than are women. This is in agreement with several reports on sex-specific differences with regard to the survival of total knee replacements 30,31 , including one by the SKAR 32 .…”

The Female Knee: Anatomic Variations and the Female-specific Total Knee Design

“…Ten studies reported results in a numeric, statistical form ( Table 1). Eight of these papers [3,12,19,29,30,32,34,36] totaling 77,449 TKAs with 5-to 15-year followups showed women have better results than men. One study [33] using a simplified, subjective, patient-reported satisfaction survey with a 6-year followup reported 84.5% of men were either satisfied or very satisfied after their TKA compared with 84.0% of women.…”

Kinematics of medial osteoarthritic knees before and after posterior cruciate ligament retaining total knee arthroplasty

“…8,38 However, other studies reported different tibial rotation patterns in OA knees. 2,17 Siston et al 17 found internal rotation of 4.9 ± 4.1…”