Total Knee Arthroplasty for Patients Younger Than 55 Years

Ranawat, Chitranjan S.; Padgett, Douglas E.; Ohashi, Y

doi:10.1097/00003086-198911000-00007

Cited by 75 publications

(37 citation statements)

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“…This was better than reported by Laskin (1990;19%), Rand and Ilstrup (1991;18%), and Elke et al (1995;19%) but not so good as reported by Ranawat et al (1989; or Aglietti et al (1995;4%). As a consequence of the low revision rate and the fairly large number of models used, we found no underperforming model.…”

Section: Discussionmentioning

confidence: 49%

Knee arthroplasty in rheumatoid arthritis: A report from the Swedish Knee Arthroplasty Register on 4, 381 primary operations 1985–1995

Robertsson

Knutson

Lewold

et al. 1997

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 49%

Knee arthroplasty in rheumatoid arthritis: A report from the Swedish Knee Arthroplasty Register on 4, 381 primary operations 1985–1995

Robertsson

Knutson

Lewold

et al. 1997

Acta Orthopaedica Scandinavica

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“…Cochran's Q-testing indicated significant heterogeneity among the 13 studies, with p values of 0 calculated for pain, clinical score, incomplete, and functional score. Five studies reported results for 414 TKAs without differentiating between lower demand patients with inflammatory arthropathy and potentially higher-demand patients with osteoarthritis or posttraumatic arthritis [5,10,11,16,28]. The mean improvement in KS clinical score was 43.6 points in these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Only six of the 13 articles that met our inclusion criteria focused specifically on patients with posttraumatic arthritis or osteoarthritis [7,9,22,24,32,35]. Five studies included patients with a predominance of rheumatoid arthritis without distinguishing clinical outcomes on the basis of diagnosis or other potential considerations [5,10,11,16,28], and two studies exclusively reported on patients with rheumatoid arthritis [4,34]. Second, although variations in surgical technique occurred in most studies, clinical scores were not reported specific to the techniques used, including posterior cruciate ligament management [4,16,32], fixation choice [22,24], tibial component modularity [5,10], and patellar management [11,16].…”

Section: Discussionmentioning

confidence: 99%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to define the best practices to enhance clinical performance and implant longevity. Questions/purposes We systematically reviewed the literature to assess: (1) how TKAs perform in young patients; (2) whether the TKA is a durable procedure for young patients, and (3) what guidance the literature outlines for TKA in young patients. Methods We searched the literature between 1950 and 2009 for all studies reporting on TKAs for patients younger than 55 years that documented clinical and radiographic assessments with a minimum 2-year followup. Thirteen studies, reporting on 908 TKAs performed for 671 patients, met these criteria. Results Mean Knee Society clinical and functional scores increased by 47 and 37 points, respectively. Implant survivorship was reported between 90.6% and 99% during the first decade and between 85% and 96.5% during the second decade of followup. The literature does not direct specific techniques for TKA for young patients.Conclusions TKA provides surgeon-measured clinical and functional improvements with a moderate increase in second-decade implant failures.

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“…[5][6][7][8][9] There is controversy about whether to retain or to substitute the PCL during the TKR procedure. Compared with posterior stabilized designs, the well-known advantages of cruciate-retaining TKR include the preservation of an important stabilizing structure, more consistent reconstruction of the joint line, improved stair climbing ability and greater conservation of the bone.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Long-term results of TKR for rheumatoid knees have been well documented, with a reported survival rate of the prosthesis between 81% and 97.7% at more than 10 years of follow-up. [5][6][7][8][9] However, there is controversy about whether to retain or excise the posterior cruciate ligament (PCL) in rheumatoid knees because attenuation of the ligament is often present in this subgroup of patients. 10 The purpose of this retrospective study was to report our more than 15 years of clinical and radiological results of cruciate-retaining TKR using different fixation techniques in patients with RA.…”

mentioning

confidence: 99%

Long-term results of cruciate-retaining total knee replacement in patients with rheumatoid arthritis: a minimum 15-year review

et al. 2015

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Background:There is controversy about whether to retain or excise the posterior cruciate ligament in rheumatoid knees because attenuation of the ligament is often present in this subgroup of patients. We reviewed more than 15 years of results of cruciate-retaining total knee replacements (TKRs) in patients with rheumatoid arthritis. Methods:We reviewed patients' charts and radiographs to evaluate knee range of motion and flexion contractures, component loosening and osteolysis at the bonecement interface. Our primary outcome was revision of a femoral or tibial component for any reason, and the secondary outcome was revision for any reason and periprosthetic fracture during the follow-up period.Results: Our study included 112 patients (7 men, 105 women, 176 knees). Their mean age was 49.3 (range 33-64) years. Twenty-one patients died and 16 were lost to followup, leaving 75 patients (119 knees) with a minimum follow-up of 15 (mean 16.1) years for our analysis. Of these, 61 patients (101 knees) were available for clinical and radiological evaluation at the final follow-up assessment. At a mean of 12.2 (range 6-16) years, revision was necessary in 14 patients (19 knees), including 1 patient with an infection. Eleven patients (11 knees) had periprosthetic fractures at a mean of 11.4 (range 5-14) years after the index operation. The survival rate, with the end point being revision of the femoral or tibial component for any reason, was 98.7% at 10 years and 83.6% at 17 years. The survival rate of revision and periprosthetic fracture was 97.6% at 10 years and 76.9% at 17 years. Conclusion:Special attention should be paid to component loosening or periprosthetic fracture after more than 10 years of follow-up in this subgroup of patients. Contexte :On ne s'entend pas sur la nécessité de conserver ou d'exciser le ligament croisé postérieur dans les genoux rhumatoïdes en raison de l'affaiblissement du ligament, souvent présent chez cette catégorie de patients. Nous avons passé en revue sur plus de 15 ans les résultats de prothèses totales du genou (PTG) avec préservation du ligament croisé chez des patients atteints de polyarthrite rhumatoïde.Méthodes : Nous avons examiné les dossiers et les radiographies des patients pour évaluer l'amplitude de mouvement et les contractures en flexion des genoux, le descellement des composants et l'ostéolyse à l'interface os-ciment. Notre paramètre principal était la révision d'un composant fémoral ou tibial, peu importe la raison, et le paramètre secondaire était la révision, peu importe la raison, ainsi que les fractures périprothé-tiques durant la période de suivi.Résultats : Notre étude a regroupé 112 patients (7 hommes, 105 femmes; 176 genoux). L'âge moyen était de 49,3 ans (entre 33 et 64 ans). Vingt-et-un patients sont décédés et 16 ont été perdus au suivi, ce qui laissait 75 patients (119 genoux) et un suivi minimum de 15 ans (moyenne 16,1 ans) pour notre analyse. Parmi ces patients, 61 (101 genoux) étaient disponibles pour évaluation clinique et radiologique à la dernière évaluat...

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Total Knee Arthroplasty for Patients Younger Than 55 Years

Cited by 75 publications

References 0 publications

Knee arthroplasty in rheumatoid arthritis: A report from the Swedish Knee Arthroplasty Register on 4, 381 primary operations 1985–1995

Knee arthroplasty in rheumatoid arthritis: A report from the Swedish Knee Arthroplasty Register on 4, 381 primary operations 1985–1995

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Long-term results of cruciate-retaining total knee replacement in patients with rheumatoid arthritis: a minimum 15-year review

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