Total Knee Arthroplasty in Younger Patients: A 13-Year Follow-Up Study

Abstract

Total knee arthroplasty (TKA) is a well-established treatment at the end stage of a degenerated knee joint. This operative treatment generally relieves pain, improves physical function, and has a high level of patient satisfaction, especially in the elderly. Younger patients, however, are demanding and have a higher level of physical activity compared to elderly patients. One could therefore expect more mechanical problems such as prosthetic loosening and polyethylene wear after long-term follow-up. The goal of this retrospective cohort study was to determine the survival and long-term results of TKA in young patients. Patients who received a TKA at age 60 years or younger for any reason were included. Minimum follow-up was 10 years. Thirty-nine TKAs (Anatomic Graduate Components; Biomet, Warsaw, Indiana) in 31 patients were included. Average patient age was 52.6 years. There were 3 revisions because of infection; in 1 knee the patella was revised because of aseptic loosening. After an average 13-year follow-up, the survival rate was 89.7% and function scores showed a reasonably functioning TKA. There was no difference in survival rate and function scores between patients with rheumatoid arthritis and those with primary or secondary (posttraumatic) osteoarthritis. Our experience with TKA in a younger patient population has been encouraging. The risk of loosening and wear of the implant in our study is low, and this type of TKA also seems to be an effective and safe treatment for younger patients.

Causes of Failure after Total Knee Arthroplasty in Osteoarthritis Patients 55 Years of Age or Younger

“…Odland et al10) stated that there would be difference in the outcomes of TKA between rheumatoid arthritis patients and degenerative arthritis patients. On the other hand, Bisschop et al1) reported that the survival rates and function scores were not significantly different between the rheumatoid arthritis patients and degenerative arthritis patients in ≤60 years of age cohorts. In our study, the TKA failure rate was 7% in the ≤55 years of age group and 2% in the >55 years of age group.…”

“…It has demonstrated excellent clinical efficacy in terms of postoperative pain, physical function, and patient satisfaction and contributed to long-term implant survival and patient's quality of life1,2). The procedure has been performed commonly on elderly patients and rarely on young patients with knee joint disorders accompanied by severe pain, such as rheumatoid arthritis3,4).…”

Investigating well-being, work limitations and preferences for self-management education and peer support among younger people with hip and knee osteoarthritis: protocol for a cross-sectional study

“…However, despite the unique set of pressures faced by younger people (including work responsibilities and parenting roles), there has been little research into the well-being of those with hip or knee OA. As most research involving younger people with OA has focused on the outcomes of surgery to repair or replace damaged joints,7 8 the quality of life and health status experienced by younger people remain poorly understood. This would form an important baseline in order to understand the impact of any intervention.…”

Endoprothetik des rheumatischen Kniegelenks

“…3 7 Bei der 55-jäh-rigen Rheumatikerin bestand bei Erstvorstellung eine massive Destruktion des medialen Tibiaplateaus mit höchstgradiger Instabilität des Kniegelenks (a); Versorgung mit teilgekoppelter Knieprothese (b) tation eine verbesserte Ausrichtung der femoralen [13] und tibialen Komponente [12] sowie eine geringere Abweichung bei der Rekonstruktion der mechanischen Beinachse [13] beschrieben. Demgegenüber werden als Nachteil längere Operationszeiten sowie Frakturen im Bereich der eingebrachten Markierungsnägel [2] beschrieben.…”