Total knee arthroplasty on the rise in younger patients: Are we sure that past performance will guarantee future success?
✍ Scribed by Elena Losina; Jeffrey N. Katz
- Publisher
- John Wiley and Sons
- Year
- 2012
- Tongue
- English
- Weight
- 38 KB
- Volume
- 64
- Category
- Article
- ISSN
- 0004-3591
No coin nor oath required. For personal study only.
✦ Synopsis
Knee osteoarthritis (OA) is a highly prevalent and disabling problem, affecting nearly 10 million adults in the US (1). Because currently available therapies do not reverse cartilage loss and other structural abnormalities associated with OA, the disease process may progress insidiously. Many patients with advanced OA become candidates for total knee arthroplasty (TKA). TKA is remarkably effective, with perioperative mortality rates of less than 1%, annual rates of failure leading to revision surgery of less than 1%, and rates of symptom relief exceeding 85% (2,3). Over 600,000 TKAs were performed in the US in 2009, with inpatient costs exceeding $9 billion (4). Utilization of TKA is likely to increase further.
Data from the US indicate that growth in use of TKA has occurred primarily in patients 45-64 years of age (4,5). In this issue of Arthritis & Rheumatism, Leskinen et el (6) present the results of a population-based study describing trends in TKA utilization in Finland among individuals under the age of 60 years who have knee OA. The authors used data from the Finnish Arthroplasty Registry, which currently includes more than 90% of all TKA cases performed in Finland. The authors demonstrated that in Finland, as in the US, TKA utilization increased dramatically in the group ages 50-59 years. Over the course of 25 years, utilization of TKA in persons younger than age 60 years increased more than 20-fold, with a 40-fold increase in women. The greatest increase in TKA utilization was observed in