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Comparable outcomes after total knee arthroplasty in patients under 55 years than in older patients: a matched prospective study with minimum follow-up of 10 years

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare outcomes after TKA for osteoarthritis between patients younger than 55 years and older patients.

Methods

A cohort of 61 patients aged 55 years or younger was prospectively matched for gender, body mass index and knee function with patients with median age of 66 (range 60–70) years. Clinical evaluation was performed by the Knee Society scores (KSS), reduced Western Ontario and McMasters Universities (WOMAC) and Short-Form 12 (SF12) questionnaires. Radiological evaluation was also performed.

Results

The median follow-up was 12 (range 10–14) years. Survival at 14 years was 96.7% (95% CI 92–100%) in the younger group and 98.2% (95% CI 95–100%) in the older group (n.s.). There was no deep infection or loosening of femoral or patellar component in either group. In the younger group, 2 patients required revision (aseptic tibial loosening at 8 years, and polyethylene wear at 10 years). In the older group, there was 1 revision (aseptic tibial loosening). Revision rate was not significantly different (n.s.). Multivariate analysis showed no significant relationship between revision and age, gender or BMI. At 5-year follow-up, there were no significant differences between groups in KSS knee or function, WOMAC pain or function, or SF12 physical or mental, but in the last evaluation there were better results in younger patients for KSS-function (p = 0.018), WOMAC-function (p = 0.028), SF12-physical (p = 0.001) and SF12-mental (p = 0.035), although these differences were not clinically relevant. A significant decline was noted for KSS-function in either group from 5-year to at last follow-up.

Conclusions

The TKA survival in younger patients was comparable to older active patients, without increased complications or revisions at a minimum follow-up of 10 years. Primary hybrid TKA can provide successful pain relief, function and quality of life in younger patients than 55 years with osteoarthritis. TKA is a suitable option for these young patients with appropriate surgical indications.

Level of evidence

II.

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Authors’ contributions

ALU conceived the study and its design, participated in its coordination and performed the statistical analysis and drafting the manuscript. DMM was involved in the acquisition of data, analysis and interpretation of data, drafting the manuscript and final approval. FAMM was involved in the acquisition of data, analysis and interpretation of data, drafting the manuscript and final approval. LMG was involved in the acquisition of data, analysis and interpretation of data, drafting the manuscript and final approval. FALP was involved in drafting the manuscript and revising it critically for important intellectual content. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain

    Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Francisco A. Miralles-Muñoz & Luis Marco-Gómez

  2. Traumatology and Orthopaedia, Miguel Hernandez University, Elche, Alicante, Spain

    Alejandro Lizaur-Utrilla & Fernando A. Lopez-Prats

Authors
  1. Alejandro Lizaur-Utrilla
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  2. Daniel Martinez-Mendez
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  3. Francisco A. Miralles-Muñoz
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  4. Luis Marco-Gómez
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  5. Fernando A. Lopez-Prats
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Corresponding author

Correspondence to Alejandro Lizaur-Utrilla.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

The appropriate institutional review board of Elda University Hospital for human subject research approved this study (ID: 2000-112).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Lizaur-Utrilla, A., Martinez-Mendez, D., Miralles-Muñoz, F.A. et al. Comparable outcomes after total knee arthroplasty in patients under 55 years than in older patients: a matched prospective study with minimum follow-up of 10 years. Knee Surg Sports Traumatol Arthrosc 25, 3396–3402 (2017). https://doi.org/10.1007/s00167-016-4406-5

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  • DOI: https://doi.org/10.1007/s00167-016-4406-5

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