Total knee arthroplasty reduces the risk of mortality in osteoarthritis patients up to 12 years: A Korean national cohort longitudinal follow-up study

Abstract

Introduction: Mortality rates and causes of death after total knee arthroplasty (TKA) are of great interest to surgeons. However, there is a shortage of studies regarding those of the Asian population. The aim of this study was to compare the mortality rate and causes of death in patients after TKA to the general population. Methods: National sample cohort data from the Korean Health Insurance Review and Assessment Service were used. In this study, 1:4 matched patients after TKA (TKA group: 5072) and general participants (control group: 20,288) were selected as subjects. Their average follow-up duration was 57.2 months ranging from a year up to 12 years. The matches were processed for age, gender, income, region of residence, and past medical history. Mortality rates and causes of death were compared between groups. Regarding the mortality rates, we also performed subgroup analyses according to age. Results: Adjusted hazard ratio (HR) of the TKA group for mortality rate was less than 1 with significance (adjusted HR = 0.61 (95% confidence interval = 0.54–0.70, p < 0.001)). The ratios were less than 1 for both age groups (<70 and ≥70 years), respectively; however, for patients under 70, they were insignificant. Among the 11 major causes of death, the circulatory disease showed the most significantly reduced mortality rate for the TKA group compared to the control group. The neoplasm was the only other cause with a significantly reduced mortality rate for the TKA group. Conclusion: The mortality rate in the TKA group was significantly lower than in the control group up to 12 years after the surgery in Korea. Among the major causes of death, circulatory disease and neoplasm showed a significant reduction in the mortality rate of the TKA group compared with the control group.

Continuing use of aspirin in total knee arthroplasty: safe or not?

“…For TKA, the indications included almost all end-stage knee joint diseases, such as osteoarthritis, rheumatoid arthritis (RA), and hemophilic arthritis (HA). Among these, osteoarthritis is no doubt the leading cause which is a chronic degenerative joint disease closely related with aging [2,17]. Thus, for the consistency of age and joint diseases, only osteoarthritis patients in our database were included.…”

“…Total knee arthroplasty (TKA) is considered as one of the most successful surgeries that can correct the deformity and restore the function of the knees [1]. With increasing life expectancy, a growing number of elderly patients who suffer from osteoarthritis and other joint diseases choose to undertake TKA to improve life quality [2][3]. However, many of them have various comorbidities which requires taking medications during the perioperative period [3].…”

“…In our database, the prevalence of using aspirin when admitted to hospital was more than 15% in all TKA patients from 2014 to 2019. It would be more in the osteoarthritis patients because of their older age [2]. Therefore, it is of great importance to manage the use of aspirin during the perioperative period of TKA.…”

Advantages and challenges of stem cell therapy for osteoarthritis (Review)

“…However, the procedure for joint replacements may cause unbearable pain and requires a long duration for rehabilitation. The adverse outcomes observed in patients who undergo total knee replacement surgery include myocardial infarction, infections and pulmonary embolism ( 34 ).…”

Understanding the 30-day mortality burden after revision total knee arthroplasty

“…While the benefits of total knee arthroplasty (TKA) are welldocumented [1,2], concerns regarding the threat of complication in the setting of TKA, and to a great degree, revision TKA, remain [3,4]. Increasing lifespan of the general population and higher prevalence of arthroplasty among younger patients has precipitated a greater demand for revision procedures, with a projected increase in revision TKA of 78%-182% over the next 10 years [5,6].…”