Artikel
Long-term results of primary total knee arthroplasty performed in patients 35 years of age and younger
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Autoren
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Thomas J. Heyse
- Klinik Rotes Kreuz, Frankfurt am Main, Germany
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Ryan Cheng
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, United States
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Ethan Krell
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, United States
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Yu-Fen Chiu
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, United States
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Jeffrey Stimac
- Norton Orthopedic Institute, Louisville, KY, United States
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Matthew Abdel
- Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN, United States
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Mark P. Figgie
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, United States
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Jason Blevins
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, United States
| Veröffentlicht: | 23. Oktober 2023 |
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Gliederung
Text
Objectives: Total knee arthroplasties (TKA) for patients 35 years of age and younger are rare but necessary for patients with diseases such as juvenile idiopathic arthritis, avascular necrosis, osteoarthritis, and rheumatoid arthritis. Few studies have examined the long-term survivorship and clinical outcomes of TKAs in a large cohort of young patients.
Methods: A retrospective registry review identified 185 TKAs in 119 patients younger than 35 years between 1985 and 2010 performed at a single institution. The primary outcome was failure, defined as reoperation for any reason. Patient-reported outcomes were assessed at two time points: 2011–2012 and 2018–2019, with response rates of 89% and 65%, respectively.
Results and conclusion: The average age was 26 (12–35) years. Mean follow-up was at 17 (8–33) years. Survivorship decreased from 84% (95% CI: 79–90) at 5 years to 70% (95% CI: 64–77) at 10 years to 37% (95% CI: 29–45) at 20 years. Risk factors for failure included increasing age at the time of surgery (HR = 1.3) and the use of constrained (HR = 1.7) or hinged prostheses (HR = 4.3). Eighty-six percent of patients reported that their surgery resulted in “a great improvement” or better. Seventy-six percent of patients achieved PASS on KOOS JR at 20 years post-TKA.
Survivorship of total knee arthroplasties in young patients is less favorable than expected, but patient-reported functional outcomes were excellent. Revision risk increased with older age and higher levels of constraint.
