A large proportion of patients undergoing total knee arthroplasty (TKA) have severe osteoarthritis in both knees and may consider either simultaneous or staged bilateral TKA. The implications of staged versus simultaneously bilateral TKA for return to work are not well understood. We hypothesized that employed patients who underwent simultaneous bilateral TKA would have significantly fewer days missed from work compared to the sum of days missed from each surgery for patients who underwent staged bilateral TKA. The prospective arthroplasty registry at Hospital for Special Surgery was utilized. We identified 61 employed patients who had undergone staged bilateral TKA and 152 employed patients who had undergone simultaneous bilateral TKA and had completed the registry's return to work questionnaire. Baseline characteristics and patient reported outcome scores were evaluated. We used a linear regression model, adjusting for potential confounders including age, sex, pre-op BMI, and work type (sedentary, moderate, high activity, or strenuous), to analyze workdays lost after staged versus simultaneous bilateral TKA.Introduction
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Primary total knee arthroplasties (TKA) performed in younger patients raise concerns regarding the potential for accelerated polyethylene wear, aseptic loosening, and thus revision TKA at a younger age. The purpose of this study was to determine the long-term implant survivorship, functional outcomes, and pain relief of primary TKA performed in patients under 35 years of age. A retrospective review of our institutional registry identified 185 TKAs performed in 119 patients under the age of 35 between 1985 and 2010. Medical records and radiographs were reviewed. Patients were contacted for two serial questionnaires in 2011–2012 and again in 2018. Implant survivorship was calculated using Kaplan-Meier survivorship curves and Cox proportional hazard model. The median age was 26.1 (21.5–30.1) years, with a BMI of 23.5 (20.4–26.6) kg/m2. Median follow-up was 13.9 (8.5–19.8) years.Introduction
Methods
Total knee arthroplasty (TKA) is a successful treatment for degenerative end stage knee arthritis. Younger patients who undergo TKA may face multiple revisions during their lifetime due to aseptic loosening, infection, and instability. The purpose of this study was to compare the early complication rates and revision free survivorship between age groups undergoing TKA in a nationwide database. The PearlDiver national insurance database was queried from 2007–2015 for all patients who underwent primary TKA. Kaplan-Meier Curve survival analysis and log rank test were performed to evaluate revision rates between age groups (<40, 40–49, 50–59, 60–69, 70–79, 80–89, and ≥90 years). Complication rates were compared to rates in the age 60–79 group using multiple logistic regressions controlling for baseline demographics and comorbidities.Introduction
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