J Am Acad Orthop Surg Glob Res Rev 2025[Dec]; 9 (12): ? PMID41359919show ga
BACKGROUND: Total knee arthroplasty (TKA) in younger patients is relatively uncommon. METHODS: The PearlDiver M165Ortho data set was used to identify TKA patients aged 15 to 45 years. Primary diagnoses associated with surgery were categorized into the following groups: primary osteoarthritis (OA), posttraumatic arthritis (PTOA), rheumatoid arthritis (RA), and osteonecrosis. Ninety-day adverse events and readmissions and 10-year periprosthetic fractures, loosening, stiffness, revisions, and prosthetic joint infection (PJI) were determined. Independent predictors of adverse outcomes were identified by using multivariable analysis, and Kaplan-Meier survival analysis for 10-year revisions was performed. RESULTS: A total of 26,566 TKA patients aged 15 to 45 years were identified. Among this cohort, the diagnosis associated with surgery was OA for 22,900 (86.2%), PTOA for 1648 (6.2%), RA for 1438 (5.4%), and osteonecrosis for 580 (2.2%). For the entire study cohort, 90-day adverse events were noted for 11.1% and readmissions for 7.4%. The 10-year periprosthetic fracture rate was 0.2%, aseptic loosening rate was 3.6%, stiffness rate was 26.9%, revision rate was 7.9%, and PJI rate was 5.7%. Diagnosis associated with surgery was not predictive of 90-day outcomes or 10-year adverse periprosthetic fracture, aseptic loosening, stiffness, or revisions. On Kaplan-Meier analysis, survival was clinically similar across all diagnosis groups, ranging from 86.2% to 89.7% at 10 years. CONCLUSION: Young TKA patients experience relatively low 90-day adverse events and readmissions and long-term complications regardless of diagnosis associated with surgery. Implant survival is similarly to what is observed in older TKA.
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J+Am+Acad+Orthop+Surg+Glob+Res+Rev 2025 ; 9 (12): ?
