12
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Increased risk of early and medium-term revision after post-fracture total knee arthroplasty : Results from the Danish Knee Arthroplasty Register

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background and purpose

          Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified.

          Patients and methods

          52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA). Short-term (< 1 year), medium-term (1–5 years), and long-term (> 5 years) implant survival were analyzed using Kaplan-Meier analysis and Cox regression after age stratification (< 50, 50–70, and >70 years). In addition, indications for revision and characteristics of TKA patients with subsequent revision were determined.

          Results

          During the first 5 years, TKAs inserted due to PTFA had a higher risk of revision than OA (with adjusted hazard ratio ranging from 1.5 to 2.4 between age categories). After 5 years, no significant differences in the risk of revision were seen between the groups. Infection and aseptic loosening were the most common causes of revision in both groups, but TKA instability was a more frequent indication for revision in the PTFA group. In both groups, the revision rates were higher with younger age and extended duration of primary surgery.

          Interpretation

          We found an increased risk of early and medium-term revision of TKAs inserted due to previous fractures in the distal femur and/or proximal tibia. Predictors of revision such as age <50 years and extended duration of primary surgery were identified, and revision due to instability occurred more frequently in TKAs performed due to previous fractures.

          Related collections

          Most cited references31

          • Record: found
          • Abstract: found
          • Article: not found

          Epidemiology of adult fractures: A review.

          The epidemiology of adult fractures is changing quickly. An analysis of 5953 fractures reviewed in a single orthopaedic trauma unit in 2000 showed that there are eight different fracture distribution curves into which all fractures can be placed. Only two fracture curves involve predominantly young patients; the other six show an increased incidence of fractures in older patients. It is popularly assumed that osteoporotic fractures are mainly seen in the thoracolumbar spine, proximal femur, proximal humerus and distal radius, but analysis of the data indicates that 14 different fractures should now be considered to be potentially osteoporotic. About 30% of fractures in men, 66% of fractures in women and 70% of inpatient fractures are potentially osteoporotic.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The epidemiology of failure in total knee arthroplasty: avoiding your next revision.

            Total knee arthroplasty (TKA) is a cost effective and extremely successful operation. As longevity increases, the demand for primary TKA will continue to rise. The success and survivorship of TKAs are dependent on the demographics of the patient, surgical technique and implant-related factors. Currently the risk of failure of a TKA requiring revision surgery ten years post-operatively is 5%. The most common indications for revision include aseptic loosening (29.8%), infection (14.8%), and pain (9.5%). Revision surgery poses considerable clinical burdens on patients and financial burdens on healthcare systems. We present a current concepts review on the epidemiology of failed TKAs using data from worldwide National Joint Registries.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis

              Background and purpose Total knee replacements (TKRs) are being increasingly performed in patients aged ≤ 65 years who often have high physical demands. We investigated the relation between age of the patient and prosthesis survival following primary TKR using nationwide data collected from the Finnish Arthroplasty Register. Materials From Jan 1, 1997 through Dec 31, 2003, 32,019 TKRs for primary or secondary osteoarthritis were reported to the Finnish Arthroplasty Register. The TKRs were followed until the end of 2004. During the follow-up, 909 TKRs were revised, 205 (23%) due to infection and 704 for other reasons. Results Crude overall implant survival improved with increasing age between the ages of 40 and 80. The 5-year survival rates were 92% and 95% in patients aged ≤ 55 and 56–65 years, respectively, compared to 97% in patients who were > 65 years of age (p 65 years remained after adjustment for these factors (p < 0.001). Interpretation Young age impairs the prognosis of TKR and is associated with increased revision rates for non-infectious reasons. Diagnosis, sex, type of TKR, use of patellar component, and fixation method partly explain the differences, but the effects of physical activity, patient demands, and obesity on implant survival in younger patients warrant further research.
                Bookmark

                Author and article information

                Journal
                Acta Orthop
                Acta Orthop
                IORT
                Acta Orthopaedica
                Taylor & Francis
                1745-3674
                1745-3682
                June 2017
                14 February 2017
                : 88
                : 3
                : 263-268
                Affiliations
                [1 ]Orthopaedic Research Unit, Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg;
                [2 ]Department of Economics and Business Economics, Aarhus University, Aarhus;
                [3 ]Department of Epidemiology, Aarhus University Hospital, Aarhus, Denmark
                Author notes
                Correspondence: Galaly@ 123456me.com
                Article
                iort-88-263
                10.1080/17453674.2017.1290479
                5434593
                28464756
                4ddb3e20-b943-4296-b3aa-98443ddcf98f
                © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License ( https://creativecommons.org/licenses/by-nc/3.0)

                History
                : 25 September 2016
                : 30 December 2016
                Categories
                Knee

                Orthopedics
                Orthopedics

                Comments

                Comment on this article