Younger patients had higher early reoperation, revision rates after TKA vs older patients
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Patients 55 years of age or younger who underwent total knee arthroplasty had a nearly two times greater rate of early reoperation and component revision surgery compared with patients between 60 and 75 years of age, according to results.
James A. Keeney, MD, and colleagues retrospectively identified patient demographics, medical comorbidities, surgical revision TKA indications, timing from index TKA to revision TKA, subsequent reoperation rates, component re-revision rates and salvage procedures for 147 patients aged 55 years or younger and 276 patients between 60 and 75 years of age at the time of initial aseptic revision TKA. Researchers assessed differences in the primary variables using univariate analysis, and estimated 5-year implant survival based on either reoperation or component revision and salvage procedures using a log-rank test.
Results showed 52.5% of patients aged 55 years or younger underwent initial aseptic revision TKA within 2 years of primary TKA vs. 29% of patients between 60 and 75 years of age. Researchers also found patients aged 55 years or younger were more likely to undergo early reoperation or component re-revision after revision TKA. Patients aged 55 years or younger more commonly had infection and extensor mechanism complications, according to results. Researchers noted a 59.4% and 65.8% estimated 5-year survival rate for reoperation and re-revision, respectively, in patients aged 55 years or younger vs. 65.7% and 80.1% in patients between 60 and 75 years of age.
Although patients in both groups had similar medical comorbidities, researchers found a higher history of tobacco use among patients aged 55 years or younger and a higher rate of cardiac disease in patients between 60 and 75 years of age.
“The study has helped me to reflect on how we provide care to our patients. I was surprised to see the high number of patients that we have treated who had potentially modifiable risk factors,” Keeney told Healio Orthopedics. “While we have not always asked our patients to stop smoking before surgery, our study has helped us to recognize the importance of this. It is probably more important for patients undergoing revision knee replacement than it is for patients undergoing a first-time knee replacement surgery.”
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