Original Articles
Total knee arthroplasty in patients ≤50 years old*,**

https://doi.org/10.1054/arth.2002.32174Get rights and content

Abstract

Thirty patients (30 knees) who underwent total knee arthroplasty at age ≤50 were reviewed. These patients were operated on between July 1, 1991, and May 1, 1995, with final follow-up evaluation at a mean of 86 months (range, 60-107 months). At final evaluation, 18 knees (60%) had excellent Knee Society objective scores, 11 knees (37%) had good scores, and 1 knee (3%) had a poor score. There were no statistically significant differences in Knee Society objective scores among the cemented group (mean, 88 points), hybrid group (mean, 88 points), and noncemented group (mean, 90 points). One patient (3%) had a revision because of unexplained pain. In the other knees, there was no radiographic evidence of progressive loosening, lucencies, or change in position or alignment of the prosthesis. Total knee arthroplasty of this design, at least for the time period studied (7-year mean follow-up), has a high rate of success in patients who are ≤50 years old. Copyright 2002, Elsevier Science (USA). All rights reserved.

Section snippets

Materials and methods

At 1 institution, 35 primary TKAs (34 patients) were done in patients who were ≤50 years old between July 1, 1991, and May 1, 1995, using the Duracon Total Knee System (Stryker-Howmedica-Osteonics, Allendale, NJ). Five knees in 4 patients with a diagnosis of rheumatoid arthritis were excluded, leaving 30 knees in 30 patients out of 1,287 TKAs done during this time period. These procedures were done by the 2 senior authors (M.A.M., D.S.H.), and the surgical technique and instrumentation were

Overall clinical results

The overall ratings for all 35 knees improved from a mean Knee Society score of 49 points (range, 14-60 points) before the operation to a mean score of 89 points (range, 36-100 points) at the latest follow-up evaluation. Before the operation, all of the knees had been rated poor. At the most recent follow-up visit, there were 18 excellent, 11 good, and 1 poor result. Range of motion at final follow-up was a mean of 118° of flexion (range, 87-127°).

The data on the clinical outcomes by success or

Discussion

TKA has proved to be successful in patients >60 years old with multiple studies reporting >95% clinical and radiographic success rates at >10-year mean follow-up 6, 18. There have been fewer reports of success rates in younger patient populations. Most of these reported results are mixed concerning clinical and radiographic outcome in studies of patients with a mean age of ≤50 years. Also, most of these reports have focused on patients with a diagnosis of rheumatoid or juvenile arthritis 24, 25

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    *

    Funds were received in support of the research material described in this article from Stryker-Howmedica-Osteonics, Allendale, NJ.

    **

    Reprint requests: Michael A. Mont, MD, Sinai Hospital of Baltimore, Sinai Medical Office Building, Suite 102, 2411 West Belvedere Avenue, Baltimore, MD 21215. E-mail: [email protected]

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