Total Knee Arthroplasty in the Young Patient: Survival in a Community Registry

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

“…Because our systematic review was performed to consider TKA performance and durability, we excluded some studies [13,15,29,36] that nonetheless provide valuable information in our efforts to understand the results of TKA performed for young patients. National, academic institutional, and community registries have reported on revision surgery rates among young patients.…”

“…Rand et al reported survivorship analysis for 11,606 TKAs performed in one institution during a 22-year period and noted a lower estimated component survivorship at 10 years for patients younger than 55 years and for patients with a primary diagnosis of osteoarthritis [29]. Gioe et al reported on implant survival from a community registry for more than 1000 TKAs in patients younger than 55 years and noted higher failure rates for male patients and for patients undergoing either unicompartmental knee arthroplasty or cementless TKA [13]. Although the registry data are valuable in identifying potential implant-or technique-related implant survivorship data, important clinical questions including durability of implants under sustained high activity levels, fixation techniques, implant design selection, surgical techniques, and the influence of perioperative protocols and rehabilitation on functional recovery would be answered with greater certainty from retrospective or prospective studies conducted at a higher level of evidence.…”

“…However, recent studies reporting data from community, academic, and national registries have suggested higher TKA revision rates occur in this patient group [13,15,29,36].…”

Revision Total Knee Arthroplasty in the Young Patient: Is There Trouble on the Horizon?

“…Some authors have noted comparable implant survivorship between younger patients and their older counterparts [11][12][13][14][15][16][17] . Other investigators have reported that younger individuals may have higher cumulative revision rates 3,[18][19][20][21] . In order to improve prosthetic survivorship in young patients after primary and revision surgery, the reasons for revision and failure of revisions must be clearly established.…”

The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients

“…Advantages of UKA compared to total knee arthroplasty (TKA) are cost-effectiveness, fewer serious complications [21,24] and better postoperative functional outcome [9,27]. Increased risk of revision has been shown to be a disadvantage of this method [8].…”