Introduction: While Total Knee Arthroplasty (TKA) has produced excellent results, there is concern about its durability in younger patients. It was our hypothesis that the results in younger patients would be inferior to those of older patients.

Aim: To review the results of TKA in patients aged 50 years or younger, with at least 5 years of follow-up.

Method: All TKA patients aged 50 years or less were identified. There were 71 arthroplasties in 52 patients. Two patients had died and two were unable to be contacted, leaving 67 arthroplasties in 48 patients. The surviving knees were assessed using the Knee Society Score.

Results: The mean age at arthroplasty was 44 years (range: 22 to 50 years) and the mean follow-up was 9.6 years (range: five to 20 years). Twelve of the TKAs (17.9%) had been revised. There was no statistically significant difference in rate of revision due to pre-operative diagnosis, the type of prostheses or the type or number of previous surgical procedures. The 10-year survival with TKA revision as the endpoint was 78% and 15 year was 71%. The mean knee score was 84% and function score 69%.

Conclusion: While TKA can produce excellent results, we found a high rate of revision among patients aged 50 years or younger. We recommend that TKA be used with caution in this group as our results were inferior to those in older patients.