Key takeaways:
- A overwhelming majority of younger sufferers who bear knee alternative could not must bear revision.
- Sufferers ought to be adopted postoperatively to make sure no interventions are compromising long-term outcomes.
SAN DIEGO — Outcomes offered right here confirmed younger, energetic sufferers who underwent whole knee alternative had been extra more likely to outlive their prostheses than expertise implant failure.
“What we discovered is that [patients] had been 4 to 5 occasions extra more likely to die than to have their knee revised,” William J. Lengthy, MD, attending orthopedic surgeon at Hospital for Particular Surgical procedure, advised Healio about outcomes offered on the American Academy of Orthopaedic Surgeons Annual Assembly. “When you’ve got an arthritic knee and you might be present process joint alternative, even in your 50s, you must fear about your lifespan, not the span of your knee alternative.”
Amongst 113 TKRs carried out between 1977 and 1992 in sufferers aged 55 years and youthful, Lengthy, Aaron I. Weinblatt and colleagues evaluated 92 knees at 40-year follow-up. In line with Weinblatt, analysis coordinator at Hospital for Particular Surgical procedure, earlier follow-ups had been performed at 10, 18 and 30 years. Researchers contacted sufferers by cellphone to gather the standing of the unique TKR, and sufferers had been additionally seen in particular person for examinations and X-rays when potential, in line with the summary. Researchers used the Kaplan-Meier estimator to carry out survival evaluation of the knee replacements to measure implant longevity and affected person survivorship.
Aaron I. Weinblatt
At 40-year follow-up, Weinblatt mentioned eight TKRs had been accessible for radiographic assessment. All prostheses had been nicely positioned and nicely aligned, there have been no nonprogressive radiolucent strains or osteolysis, and a median of three° of valgus.
Though solely 19% of sufferers had been alive at 40-year follow-up, Weinblatt mentioned 77% of sufferers had retained their authentic tibial femoral implants, suggesting that the overwhelming majority of sufferers lived the remainder of their lives with no need a knee revision or had been nonetheless residing with them in place.
In line with Lengthy, modifications have been made in joint alternative to enhance affected person care, equivalent to shorter hospital stays, fast rehabilitation and modifications in prosthesis design. Nonetheless, he mentioned it is very important proceed learning outcomes after TKR to make sure not one of the interventions are compromising long-term outcomes.
“Every of those modifications is finished with all good intentions however we have to proceed to review these sufferers rigorously and comply with them over time and be certain that the surgeons of immediately are attaining and residing out to those excessive requirements of our senior companions from a era in the past,” Lengthy mentioned.
For extra info:
William J. Lengthy, MD, needs to be contacted by way of mediarelations@hss.edu.
Sources/Disclosures
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Weinblatt AI, et al. Paper 416. Introduced at: American Academy of Orthopaedic Surgeons Annual Assembly; March 10-14, 2025; San Diego.
Disclosures:
Lengthy experiences being a worldwide developer for Zimmer. Weinblatt experiences no related monetary disclosures.
