Casey Tingle , 2025-05-02 14:59:00
Key takeaways:
- A vast majority of young patients who undergo knee replacement may not need to undergo revision.
- Patients should be followed postoperatively to ensure no interventions are compromising long-term outcomes.
SAN DIEGO — Results presented here showed young, active patients who underwent total knee replacement were more likely to outlive their prostheses than experience implant failure.
“What we found is that [patients] were four to five times more likely to die than to have their knee revised,” William J. Long, MD, attending orthopedic surgeon at Hospital for Special Surgery, told Healio about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting. “If you have an arthritic knee and you are undergoing joint replacement, even in your 50s, you should worry about your lifespan, not the span of your knee replacement.”
Among 113 TKRs performed between 1977 and 1992 in patients aged 55 years and younger, Long, Aaron I. Weinblatt and colleagues evaluated 92 knees at 40-year follow-up. According to Weinblatt, research coordinator at Hospital for Special Surgery, earlier follow-ups were conducted at 10, 18 and 30 years. Researchers contacted patients by phone to collect the status of the original TKR, and patients were also seen in person for examinations and X-rays when possible, according to the abstract. Researchers used the Kaplan-Meier estimator to perform survival analysis of the knee replacements to measure implant longevity and patient survivorship.
Aaron I. Weinblatt
At 40-year follow-up, Weinblatt said eight TKRs were available for radiographic review. All prostheses were well positioned and well aligned, there were no nonprogressive radiolucent lines or osteolysis, and an average of 3° of valgus.
Although only 19% of patients were alive at 40-year follow-up, Weinblatt said 77% of patients had retained their original tibial femoral implants, suggesting that the vast majority of patients lived the rest of their lives without needing a knee revision or were still living with them in place.
According to Long, changes have been made in joint replacement to improve patient care, such as shorter hospital stays, rapid rehabilitation and changes in prosthesis design. However, he said it is important to continue studying outcomes after TKR to ensure none of the interventions are compromising long-term outcomes.
“Each of these changes is done with all good intentions but we need to continue to study these patients carefully and follow them over time and ensure that the surgeons of today are achieving and living out to these high standards of our senior partners from a generation ago,” Long said.
For more information:
William J. Long, MD, wishes to be contacted through mediarelations@hss.edu.
Sources/Disclosures
Collapse
Weinblatt AI, et al. Paper 416. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.
Disclosures:
Long reports being a global developer for Zimmer. Weinblatt reports no relevant financial disclosures.
