Meeting increased demand for total knee replacement and follow-up
| Autor: | John B. Meding, Kenneth E. Davis, Merrill A. Ritter, A. Farris |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Adolescent Knee Joint Total knee replacement Total knee arthroplasty Young Adult Interquartile range medicine Humans Orthopedics and Sports Medicine Revision rate Prospective Studies Arthroplasty Replacement Knee High body mass index Median time to failure Aged Aged 80 and over business.industry Middle Aged Survival Analysis Prosthesis Failure Surgery Patient population Treatment Outcome Female Joint Diseases Outcome data Knee Prosthesis business Follow-Up Studies |
| Zdroj: | The Bone & Joint Journal. :1484-1489 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.95b11.32467 |
| Popis: | The strain on clinic and surgeon resources resulting from a rise in demand for total knee replacement (TKR) requires reconsideration of when and how often patients need to be seen for follow-up. Surgeons will otherwise require increased paramedical staff or need to limit the number of TKRs they undertake. We reviewed the outcome data of 16 414 primary TKRs undertaken at our centre to determine the time to re-operation for any reason and for specific failure mechanisms. Peak risk years for failure were determined by comparing the conditional probability of failure, the number of failures divided by the total number of TKRs cases, for each year. The median times to failure for the most common failure mechanisms were 4.9 years (interquartile range (IQR) 1.7 to 10.7) for femoral and tibial loosening, 1.9 years (IQR 0.8 to 3.9) for infection, 3.1 years (IQR 1.6 to 5.5) for tibial collapse and 5.6 years (IQR 3.4 to 9.3) for instability. The median time to failure for all revisions was 3.3 years (IQR 1.2 to 8.5), with an overall revision rate of 1.7% (n = 282). Results from our patient population suggest that patients be seen for follow-up at six months, one year, three years, eight years, 12 years, and every five years thereafter. Patients with higher pain in the early post-operative period or high body mass index (≥ 41 kg/m2) should be monitored more closely.Cite this article: Bone Joint J 2013;95-B:1484–9. |
| Databáze: | OpenAIRE |
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