Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Arch Orthop Trauma Surg. 2024 Sep;144(9):4077-4083. doi: 10.1007/s00402-024-05198-5. Epub 2024 Mar 4.
Growing numbers of younger patients are electing to undergo total knee arthroplasty (TKA) for end-stage osteoarthritis. The purpose of this study was to compare established literature regarding TKA outcomes in patients under age 55, to data from an ongoing longitudinal young patient cohort curated by our study group. Further, we aimed to provide a novel update on survivorship at 40 years post-TKA from our longitudinal cohort.
A literature search was conducted using the electronic databases PubMed, Embase, and Cochrane Library, using terms related to TKA, patients under age 55, and osteoarthritis. Demographic and outcome data were extracted from all studies that met the inclusion criteria. Data were divided into the "longitudinal study (LS) group," and the "literature review (LR) group" based on the patient population of the study from which it came.
After screening, 10 studies met the inclusion criteria; 6 studies comprised the LR group, and 4 studies comprised the LS group. 2613 TKAs were performed among the LR group, and 114 TKAs were longitudinally followed in the LS group. The mean patient ages of the LR and LS groups were 46.1 and 51, respectively. Mean follow-up was 10.1 years for the LR group. Mean postoperative range of motion was 113.6° and 114.5° for the LR and LS groups, respectively. All-cause survivorship reported at 10 years or less ranged from 90.6% to 99.0%. The LS cohort studies reported survivorship ranges of 70.1-70.6% and 52.1-65.3% at 30 and 40 years, respectively.
Young TKA patients demonstrated improved functionality at each follow-up time point assessed. Survivorship decreased with increasing lengths of follow-up, ultimately ranging from 52.1-65.3% at 40 years post-TKA. The paucity of literature on long-term TKA outcomes in this patient population reinforces the necessity of further research on this topic.
越来越多的年轻患者选择接受全膝关节置换术（TKA）来治疗终末期骨关节炎。本研究的目的是比较年轻患者（<55 岁）接受 TKA 的文献中已建立的结果，并与我们研究小组进行的一项正在进行的纵向年轻患者队列的数据进行比较。此外，我们旨在提供来自我们纵向队列的 TKA 后 40 年的生存率的最新信息。
使用电子数据库 PubMed、Embase 和 Cochrane Library 进行文献检索，使用与 TKA、<55 岁的患者和骨关节炎相关的术语。从符合纳入标准的所有研究中提取人口统计学和结果数据。根据研究中的患者人群，将数据分为“纵向研究（LS）组”和“文献综述（LR）组”。
经过筛选，有 10 项研究符合纳入标准；其中 6 项研究为 LR 组，4 项研究为 LS 组。LR 组共进行了 2613 例 TKA，LS 组对 114 例 TKA 进行了纵向随访。LR 组和 LS 组的平均患者年龄分别为 46.1 岁和 51 岁。LR 组的平均随访时间为 10.1 年。LR 组和 LS 组的术后平均关节活动度分别为 113.6°和 114.5°。报告的 10 年及以下全因生存率范围为 90.6%至 99.0%。LS 队列研究报告的 30 年和 40 年生存率分别为 70.1-70.6%和 52.1-65.3%。
年轻 TKA 患者在每个评估的随访时间点都表现出更好的功能。随着随访时间的延长，生存率逐渐下降，最终在 TKA 后 40 年的生存率范围为 52.1-65.3%。关于该患者群体的长期 TKA 结果的文献很少，这强调了进一步研究这一主题的必要性。
