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Total Knee Replacement Outcomes Improve

Current replacements last longer than those performed in the early 1990s

THURSDAY, July 27 (HealthDay News) -- A review of the Finnish Arthroplasty Registry shows that total knee replacement surgery has improved since the early 1990s, with the time to first revision getting longer, according to a report in the July issue of The Journal of Bone & Joint Surgery.

Yrjo T. Konttinen, M.D., Ph.D., of Biomedicum Helsinki at the University of Helsinki, Finland, and colleagues reviewed the nationwide registry to present the results of revision total knee arthroplasty and describe risk factors for poor survival of the replacement, requiring repeat revision.

The investigators found the overall survival of the prosthesis at two years after surgery was 95 percent and dropped progressively up to 10 years, where the rate was 79 percent. Risk factors for a second surgery included younger age, surgery performed 10 years ago compared with more recent surgery, a shorter time between primary surgery and total revision, the reason for revision, and cementless fixation. The five-year prosthetic survival rate was 85 percent of those having their first revision between 1990-1995, compared with 92 percent for those patients in 1996-2002.

"We believe that normal aging as well as the deconditioning effect of disease (osteoarthritis and rheumatoid arthritis) and its treatment (primary total knee replacement) may lead to a reduced activity level, which, together with a presumed reluctance to operate on elderly patients, protects against repeat revisions," the authors conclude.

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