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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2015

01.06.2015 | knee

Ten-year mortality risk predictors after primary total knee arthroplasty for osteoarthritis

verfasst von: Alejandro Lizaur-Utrilla, Santiago Gonzalez-Parreño, Francisco A. Miralles-Muñoz, Fernando A. Lopez-Prats

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 6/2015

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Abstract

Purpose

To determine predictors of mortality up to 10 post-operative years.

Methods

A cohort of 1,569 consecutive patients who underwent primary cementless total knee arthroplasty (TKA) for osteoarthritis was prospectively evaluated. Patient mortality was compared to the general population using standardized mortality ratios (SMR). The effects on patient mortality and surgical data, as well as post-operative outcomes, were analysed using Cox regression analysis.

Results

The 10-year survival was 88.9 % in females and 73.4 % in males (p = 0.001). The SMR were higher for females under 50 years (213.1 %) and for males over 70 years (170.5 %). Aged 70 or older and male gender were predictive for mortality in any post-operative time. Lengthening of the follow-up time showed different patterns of other risk mortality factors. Within 8 years, high Charlson index, poorer post-operative clinical status, and quality of life were also associated with an increased mortality risk, and obesity was protective factor. However, 10-year mortality was only associated with age, female gender, post-operative walking disability, and increasing post-operative WOMAC pain score.

Conclusion

In this study, patient-related factors that can help identify patients at risk were only age and gender, while recovery of walking ability, WOMAC pain, and SF-12 mental component were important survival factors among post-operative factors. This study identified important patient-related predictors of mortality after TKA, which may be useful in order to inform the patients of the potential risks.

Level of evidence

IV.
Literatur
2.
Zurück zum Zitat Belmont PJ Jr, Goodman GP, Waterman BR, Bader JO, Schoenfeld AJ (2014) Thirty-day postoperative complications and mortality following total knee arthroplasty: incidence and risk factors among a national sample of 15,321 patients. J Bone Joint Surg Am 96-A:20–26CrossRef Belmont PJ Jr, Goodman GP, Waterman BR, Bader JO, Schoenfeld AJ (2014) Thirty-day postoperative complications and mortality following total knee arthroplasty: incidence and risk factors among a national sample of 15,321 patients. J Bone Joint Surg Am 96-A:20–26CrossRef
3.
Zurück zum Zitat Böhm P, Holy T, Pietsch-Breitfeld B, Meisner C (2000) Mortality after total knee arthroplasty in patients with osteoarthrosis and rheumatoid arthritis. Arch Orthop Trauma Surg 120:75–78PubMed Böhm P, Holy T, Pietsch-Breitfeld B, Meisner C (2000) Mortality after total knee arthroplasty in patients with osteoarthrosis and rheumatoid arthritis. Arch Orthop Trauma Surg 120:75–78PubMed
4.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed
5.
Zurück zum Zitat Charnley J, Cupic Z (1973) The nine and ten year results of the low-friction arthroplasty of the hip. Clin Orthop Relat Res 95:9–25PubMed Charnley J, Cupic Z (1973) The nine and ten year results of the low-friction arthroplasty of the hip. Clin Orthop Relat Res 95:9–25PubMed
6.
Zurück zum Zitat Clement ND, Jenkins PJ, Brenkel IJ, Walmsley P (2012) Predictors of mortality after total knee replacement: a ten-year survivorship analysis. J Bone Joint Surg Br 94(B):200–204CrossRefPubMed Clement ND, Jenkins PJ, Brenkel IJ, Walmsley P (2012) Predictors of mortality after total knee replacement: a ten-year survivorship analysis. J Bone Joint Surg Br 94(B):200–204CrossRefPubMed
7.
Zurück zum Zitat Gill GS, Mills D, Joshi AB (2003) Mortality following primary total knee arthroplasty. J Bone Joint Surg Am 85-A:432–435PubMed Gill GS, Mills D, Joshi AB (2003) Mortality following primary total knee arthroplasty. J Bone Joint Surg Am 85-A:432–435PubMed
8.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
10.
Zurück zum Zitat Jämsen E, Puolakka T, Eskelinen A, Jäntti P, Kalliovalkama J, Nieminen J, Valvanne J (2013) Predictors of mortality following primary hip and knee replacement in the aged: a single-centre analysis of 1,998 primary hip and knee replacements for primary osteoarthritis. Acta Orthop 84:44–53CrossRefPubMedCentralPubMed Jämsen E, Puolakka T, Eskelinen A, Jäntti P, Kalliovalkama J, Nieminen J, Valvanne J (2013) Predictors of mortality following primary hip and knee replacement in the aged: a single-centre analysis of 1,998 primary hip and knee replacements for primary osteoarthritis. Acta Orthop 84:44–53CrossRefPubMedCentralPubMed
11.
Zurück zum Zitat Khan A, Emberson J, Dowd GS (2002) Standardized mortality ratios and fatal pulmonary embolism rates following total knee replacement: a cohort of 936 consecutive cases. J Knee Surg 15:219–222PubMed Khan A, Emberson J, Dowd GS (2002) Standardized mortality ratios and fatal pulmonary embolism rates following total knee replacement: a cohort of 936 consecutive cases. J Knee Surg 15:219–222PubMed
12.
Zurück zum Zitat Lie SA, Pratt N, Ryan P, Engesaeter LB, Havelin LI, Furnes O, Graves S (2010) Duration of increase in early postoperative mortality after elective hip and knee replacement. J Bone Joint Surg Am 92-A:58–63CrossRef Lie SA, Pratt N, Ryan P, Engesaeter LB, Havelin LI, Furnes O, Graves S (2010) Duration of increase in early postoperative mortality after elective hip and knee replacement. J Bone Joint Surg Am 92-A:58–63CrossRef
13.
Zurück zum Zitat Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P (2011) All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ 342:e1165CrossRef Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P (2011) All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ 342:e1165CrossRef
14.
Zurück zum Zitat Nunley RM, Lachiewicz PF (2003) Mortality after total hip and knee arthroplasty in a medium-volume university practice. J Arthroplasty 18:278–285CrossRefPubMed Nunley RM, Lachiewicz PF (2003) Mortality after total hip and knee arthroplasty in a medium-volume university practice. J Arthroplasty 18:278–285CrossRefPubMed
15.
Zurück zum Zitat Parvizi J, Sullivan TA, Trousdale RT, Lewallen DG (2001) Thirty-day mortality after total knee arthroplasty. J Bone Joint Surg Am 83-A:1157–1161PubMed Parvizi J, Sullivan TA, Trousdale RT, Lewallen DG (2001) Thirty-day mortality after total knee arthroplasty. J Bone Joint Surg Am 83-A:1157–1161PubMed
16.
Zurück zum Zitat Robertsson O, Stefánsdóttir A, Lidgren L, Ranstam J (2007) Increased long-term mortality in patients less than 55 years old who have undergone knee replacement for osteoarthritis: results from the Swedish Knee Arthroplasty Register. J Bone Joint Surg Br 89(B):599–603CrossRefPubMed Robertsson O, Stefánsdóttir A, Lidgren L, Ranstam J (2007) Increased long-term mortality in patients less than 55 years old who have undergone knee replacement for osteoarthritis: results from the Swedish Knee Arthroplasty Register. J Bone Joint Surg Br 89(B):599–603CrossRefPubMed
17.
Zurück zum Zitat Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ et al (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51:428–436PubMedCentralPubMed Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ et al (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51:428–436PubMedCentralPubMed
18.
Zurück zum Zitat Schnurr C, Jarrous M, Güdden I, Eysel P, König DP (2013) Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction. Int Orthop 37:1257–1261CrossRefPubMedCentralPubMed Schnurr C, Jarrous M, Güdden I, Eysel P, König DP (2013) Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction. Int Orthop 37:1257–1261CrossRefPubMedCentralPubMed
19.
Zurück zum Zitat Schrøder HM, Kristensen PW, Petersen MB, Nielsen PT (1998) Patient survival after total knee arthroplasty: 5-year data in 926 patients. Acta Orthop 69:35–38CrossRef Schrøder HM, Kristensen PW, Petersen MB, Nielsen PT (1998) Patient survival after total knee arthroplasty: 5-year data in 926 patients. Acta Orthop 69:35–38CrossRef
20.
21.
Zurück zum Zitat Ulm K (1990) Simple method to calculate the confidence interval of a standardized mortality ratio (SMR). Am J Epidemiol 131:373–375PubMed Ulm K (1990) Simple method to calculate the confidence interval of a standardized mortality ratio (SMR). Am J Epidemiol 131:373–375PubMed
22.
Zurück zum Zitat Vazquez-Vela Johnson G, Worland RL, Keenan J, Norambuena N (2003) Patient demographics as a predictor of the ten-year survival rate in primary total knee replacement. J Bone Joint Surg Br 85(B):52–56CrossRefPubMed Vazquez-Vela Johnson G, Worland RL, Keenan J, Norambuena N (2003) Patient demographics as a predictor of the ten-year survival rate in primary total knee replacement. J Bone Joint Surg Br 85(B):52–56CrossRefPubMed
23.
Zurück zum Zitat Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed
24.
Zurück zum Zitat World Health Organization (2000) Obesity: preventing and managing the global epidemic. World Health, Geneva World Health Organization (2000) Obesity: preventing and managing the global epidemic. World Health, Geneva
25.
Zurück zum Zitat Yang KG, Raijmakers NJ, Verbout AJ, Dhert WJ, Saris DB (2007) Validation of the short-form WOMAC function scale for the evaluation of osteoarthritis of the knee. J Bone Joint Surg Br 89(B):50–56CrossRefPubMed Yang KG, Raijmakers NJ, Verbout AJ, Dhert WJ, Saris DB (2007) Validation of the short-form WOMAC function scale for the evaluation of osteoarthritis of the knee. J Bone Joint Surg Br 89(B):50–56CrossRefPubMed
Metadaten
Titel
Ten-year mortality risk predictors after primary total knee arthroplasty for osteoarthritis
verfasst von
Alejandro Lizaur-Utrilla
Santiago Gonzalez-Parreño
Francisco A. Miralles-Muñoz
Fernando A. Lopez-Prats
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 6/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3502-2

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