Total Knee Arthroplasty in Patients Less Than 50 Years of Age: Results at a Mean of 13 Years

Karas, Vasili; Calkins, Tyler E.; Bryan, Andrew J.; Culvern, Chris; Nam, Denis; Berger, Richard A.; Rosenberg, Aaron G.; Valle, Craig J. Della

doi:10.1016/j.arth.2019.05.018

Cited by 36 publications

(32 citation statements)

References 29 publications

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“…Factors influencing revision change with time. Patient factors may affect the rate of primary procedures, such as rising patient and surgeon acceptance of knee replacement (Hamilton et al 2015), increasing rates of osteoarthritis (Hunter and Bierma-Zeinstra 2019), growing use in younger patients (Leyland et al 2016, Karas et al 2019, and also survivorship, such as longer life expectancy, increasing obesity, and higher physical activity of those receiving a replacement (Hamilton et al 2015). In addition, prosthesis designs change to improve perceived shortcomings such as wear, instability, and patellofemoral pain and tracking (Lewis et al 2020a).…”

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confidence: 99%

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

et al. 2020

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Background and purpose — Studies describing time-related change in reasons for knee replacement revision have been limited to single regions or institutions, commonly analyze only 1st revisions, and may not reflect true caseloads or findings from other areas. We used revision procedure data from 3 arthroplasty registries to determine trends and differences in knee replacement revision diagnoses. Patients and methods — We obtained aggregated data for 78,151 revision knee replacement procedures recorded by the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) for the period 2003–2017. Equivalent diagnosis groups were created. We calculated the annual proportions of the most common reasons for revision. Results — Infection, loosening, and instability were among the 5 most common reasons for revision but magnitude and ranking varied between registries. Over time there were increases in proportions of revisions for infection and decreases in revisions for wear. There were inconsistent proportions and trends for the other reasons for revision. The incidence of revision for infection showed a uniform increase. Interpretation — Despite some differences in terminology, comparison of registry-recorded revision diagnoses is possible, but defining a single reason for revision is not always clear-cut. There were common increases in revision for infection and decreases in revision for wear, but variable changes in other categories. This may reflect regional practice differences and therefore generalizability of studies regarding reasons for revision is unwise.

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confidence: 99%

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

et al. 2020

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“…Increases in the use of KR in younger patients are therefore balanced by a comparable increase in the ≥ 65 years age group. This counters the suggestion that KR has been proportionally more frequently used for younger patients over this time (Karas et al 2019). While the proportion of younger to older KR patients remained stable, the percentage increases in incidence/10 5 in the younger group were greater, a finding consistent with others (Weinstein et al 2013, Pabinger et al 2015.…”

Section: Discussionmentioning

confidence: 51%

“…Throughout the last decade, national joint replacement registries have recorded increasing yearly volumes of KR (AOAN-JRR 2018, NJR 2018, SKAR 2018. The reasons for this increase in procedure numbers are proposed to be increased surgeon and patient acceptance of KR (Hamilton et al 2015), improved longevity (Patel et al 2015), increasing incidence of osteoarthritis (OA), and use of KR in younger patients (Weinstein et al 2013, Leyland et al 2016, Karas et al 2019.…”

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confidence: 99%

Increases in the rates of primary and revision knee replacement are reducing: a 15-year registry study across 3 continents

et al. 2020

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Background and purpose — Rates of knee replacement (KR) are increasing worldwide. Based on population and practice changes, there are forecasts of a further exponential increase in primary knee replacement through to 2030, and a corresponding increase in revision knee replacement. We used registry data to document changes in KR over the past 15 years, comparing practice changes across Sweden, Australia, and the United States. This may improve accuracy of future predictions. Patients and methods — Aggregated data from the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) were used to compare surgical volume of primary and revision KR from 2003 to 2017. Incidence was calculated using population census statistics from Statistics Sweden and the Australian Bureau of Statistics, as well as the yearly active membership numbers from Kaiser Permanente. Further analysis of KR by age < 65 and ≥ 65 years was carried out. Results — All registries recorded an increase in primary and revision KR, with a greater increase seen in the KPJRR. The rate of increase slowed during the study period. In Sweden and Australia, there was a smaller increase in revision surgery compared with primary procedures. There was consistency in the mean age at surgery, with a steady small decrease in the proportion of women having primary KR. The incidence of KR in the younger age group remained low in all 3 registries, but the proportional increases were greater than those seen in the ≥ 65 years of age group. Interpretation — There has been a generalized deceleration in the rate of increase of primary and revision KR. While there are regional differences in KR incidence, and rates of change, the rate of increase does not seem to be as great as previously predicted.

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“…Early prosthetic technology, however, did not adequately simulate knee kinematics, leading to a lower return to sport rate after TKA compared to total hip arthroplasty and considerable revision rates due to polyethylene wear 5,6 . As a reflection of the population dynamics, TKA patients are getting younger, are heavier, and are more active 7 . Thus, innovative efforts in orthopaedics have been concentrated on finding the best solution to increase the harmony of metallic and plastic components of TKA to increase function, as well as durability and longevity 8 .…”

Section: Introductionmentioning

confidence: 99%

Knee Prosthesis in the Computer Era

Sezer

Bohu

Hardy

et al. 2021

Orthopaedic Surgery

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Over the past two decades, computer assistance has revolutionalized surgery and has enabled enormous advancements in knee prosthesis surgery. Total knee arthroplasty (TKA) is a hot topic of orthopaedic research. Reflecting population dynamics, its use continues to increase, especially in high demand populations. Therefore, efforts to achieve the best fit and precise alignment in TKA continue. Computer assistance is valuable for knee prosthesis surgeons in this regard. This manuscript investigated the use of computer assistance in knee prosthesis surgery. The effects of computer use on important facets of knee prosthesis surgery, such as precision, clinical aspects, and costs, were examined. Moreover, an overall review of the recent literature on the navigation and personalized cutting guides was conducted.

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Total Knee Arthroplasty in Patients Less Than 50 Years of Age: Results at a Mean of 13 Years

Cited by 36 publications

References 29 publications

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

Increases in the rates of primary and revision knee replacement are reducing: a 15-year registry study across 3 continents

Knee Prosthesis in the Computer Era

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