title: Increased risk of failure following revision total knee replacement in patients aged 55 years and younger.
abstract: The aims of this retrospective study were to compare the mid-term outcomes following revision total knee replacement (TKR) in 76 patients (81 knees) < 55 years of age with those of a matched group of primary TKRs based on age, BMI, gender and comorbid conditions. We report the activity levels, functional scores, rates of revision and complications. Compared with patients undergoing primary TKR, those undergoing revision TKR had less improvement in the mean Knee Society function scores (8.14 (-55 to +60) vs 23.3 points (-40 to +80), p < 0.001), a similar improvement in UCLA activity level (p = 0.52), and similar minor complication rates (16% vs 13%, p = 0.83) at a mean follow-up of 4.6 years (2 to 13.4). Further revision surgery was more common among revised TKRs (17% vs 5%, p = 0.02), with deep infection and instability being the most common reasons for failure. As many as one-third of patients aged < 55 years in the revision group had a complication or failure requiring further surgery. Young patients undergoing revision TKR should be counselled that they can expect somewhat less improvement and a higher risk of complications than occur after primary TKR.
authors.affiliation: Washington University in St. Louis, 660 South Euclid Ave, Campus Box 8233, Saint Louis, Missouri 63110, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Stambough
authors.affiliation: Washington University in St. Louis, 660 South Euclid Ave, Campus Box 8233, Saint Louis, Missouri 63110, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Clohisy
authors.affiliation: Washington University in St. Louis, 660 South Euclid Ave, Campus Box 8233, Saint Louis, Missouri 63110, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Barrack
authors.affiliation: Washington University in St. Louis, 660 South Euclid Ave, Campus Box 8233, Saint Louis, Missouri 63110, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Nunley
authors.affiliation: Washington University in St. Louis, 660 South Euclid Ave, Campus Box 8233, Saint Louis, Missouri 63110, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Keeney
mesh_terms: D000328:Adult; D000367:Age Factors; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications; D007593:Joint Instability / Q000150:complications; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure
keywords: Arthroplasty; Outcomes; Replacement; Revision; Total Knee; Young Patients