Old Andrew Brian, Long William John, Scott W Norman
Department of Orthopaedics, Premier Orthopaedic and Sports Medicine Associates, Chester, Pennsylvania.
Department of Orthopaedics, Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, New York.
J Knee Surg. 2017 Nov;30(9):905-908. doi: 10.1055/s-0037-1598074. Epub 2017 Mar 1.
Rates of total knee arthroplasty (TKA) in younger patients are rising significantly. A recent study performed at our institute illustrated the excellent survivorship of TKAs in patients younger than 55 years at a mean follow-up period of 25 years. This study reports on the 25 knees in this series that required revision surgery. Twenty-five revisions were performed in 24 patients. Indication for revision, clinical outcomes, and radiographs were reviewed at their most recent follow-up. Revisions were performed in 5 cases of infection, 2 cases of fracture/trauma, 17 cases of wear/loosening, and 1 case of instability. The average duration from primary TKA to revision surgery for the 25 knees was 12.5 years (range, 2-26 years). Follow-up was obtained in 24 of 25 TKAs. Nine of the 24 patients (10 knees) had died at the time of follow-up. The average duration from revision surgery to follow-up examination for the remaining knees was 10.5 years. Using the Knee Society scoring system, the average knee score was 89.0 points and the average functional score was 75.6 points. The mean Tegner activity score was 4.6 which exceeded the mean score for unrevised TKAs (2.9). The average range of motion was 119 degrees. None of the knee radiographs showed evidence of component loosening. Young patients who undergo TKA that require revision surgery had good mid-term clinical outcomes. This information is important in completing the clinical picture and outcomes associated with young patients undergoing TKA.
年轻患者全膝关节置换术（TKA）的发生率正在显著上升。我们研究所最近进行的一项研究表明，在平均随访25年的情况下，55岁以下患者的TKA具有出色的生存率。本研究报告了该系列中需要翻修手术的25例膝关节情况。24例患者进行了25次翻修手术。在最近一次随访时对翻修指征、临床结果和X线片进行了评估。翻修原因包括5例感染、2例骨折/创伤、17例磨损/松动和1例不稳定。25例膝关节从初次TKA到翻修手术的平均时间为12.5年（范围2 - 26年）。25例TKA中有24例获得了随访。24例患者中有9例（10个膝关节）在随访时死亡。其余膝关节从翻修手术到随访检查的平均时间为10.5年。使用膝关节协会评分系统，平均膝关节评分为89.0分，平均功能评分为75.6分。平均Tegner活动评分为4.6分，超过了未翻修TKA的平均评分（2.9分）。平均活动范围为119度。膝关节X线片均未显示假体松动迹象。接受需要翻修手术的TKA的年轻患者中期临床结果良好。这些信息对于完善接受TKA的年轻患者的临床情况和结果很重要。
