Original ArticlesTotal knee arthroplasty in patients ≤50 years old*,**
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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Cited by (53)
Higher Activity Level Following Total Knee Arthroplasty Is Not Deleterious to Mid-Term Implant Survivorship
2020, Journal of ArthroplastyCitation Excerpt :In a large registry analysis, young active patients ≤45 years -old had an 8 times higher revision rate for polyethylene wear and 3 times higher revision rate for aseptic loosening than the general population [22]. However, many other studies have shown excellent survivorship of >95% in younger patients undergoing TKA with modern implant designs [15,16,40,42,43]. Younger patients are at the highest risk for lifetime revision by virtue of the fact that they will live longer with their implant.
Total Knee Arthroplasty in Patients Less Than 50 Years of Age: Results at a Mean of 13 Years
2019, Journal of ArthroplastyComparison of High-Flexion Fixed-Bearing and High-Flexion Mobile-Bearing Total Knee Arthroplasties—A Prospective Randomized Study
2018, Journal of ArthroplastyCitation Excerpt :Most midterm and long-term studies on TKA in younger patients have included a relatively large percentage of patients with rheumatoid arthritis who were somewhat inactive [34–37]. Several authors [35,38–42] reported good results of TKA in younger patients with osteoarthritis at long-term follow-up. Dixon et al [43] reported a 93% survivorship of conventional TKA at 15 years for patients <67 years old.
Total Knee Arthroplasty for Osteoarthritis in Patients Less Than Fifty-Five Years of Age: A Systematic Review
2017, Journal of ArthroplastyPatient-Reported Outcomes, Quality of Life, and Satisfaction Rates in Young Patients Aged 50 Years or Younger After Total Knee Arthroplasty
2017, Journal of ArthroplastyCitation Excerpt :To our knowledge, this study represents the largest cohort of osteoarthritic patients aged 50 years or younger undergoing TKA. Several studies have investigated the outcomes and survivorship of TKA in younger patients [4,6-21]. Comparison with existing literature was difficult because of differing cohorts of patients with differences in time period, surgeons, techniques, and equipment used in each study.
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Funds were received in support of the research material described in this article from Stryker-Howmedica-Osteonics, Allendale, NJ.
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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]