Juveniles With Arthritis Benefit From TKR

Researchers at the Hospital for Special Surgery (HSS) have found that having a total knee replacement improves the long-term quality of life for patients with juvenile idiopathic arthritis. They also found that the implants did not last as long in the younger patients as they did in elderly osteoarthritic patients. The study was reported in Orthopedics Today.

“The surgery in this patient population, although performed by only a small number of highly specialized orthopedic surgeons, is life-changing, ” said Mark P. Figgie, M.D., senior author and chief of the Surgical Arthritis Service at HSS. “Joint replacement can free patients—many of them adolescents—from a life of unrelenting pain.”

Figgie and his colleagues examined Kaplan-Meier survivorship of 294 total knee replacements that surgeons had performed between 1979 and 2011 at five hospitals. At the 10-year follow-up, they found that the Kaplan-Meier survivorship was 92.2%. The 20-year survivorship was 75.5%.

Within the group of 294 there were 29 revisions. Ten patients were revised due to the failure of the polyethylene in the implant, four patients because of infection, four patients because they experienced stiffness and two patients due to fractures.

When the function of their legs was measured, the researchers found that 49% of the patients were able to walk an unlimited distance, 22% of the patients were able to walk between 5 blocks to 10 blocks and 27% were able to walk less than 5 blocks. When climbing stairs, 59% of the patients had to hold onto the railing, while 11% of the patients could not climb stairs. Additionally, 11.7% of the patients used a cane, 11.7% of the patients required a wheelchair and 6.7% of the patients required crutches.