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 "The number of knee replacements we are doing in younger and younger
patients keeps increasing every year and we need to let these
patients know that their failure rate is potentially higher," Dr.
Mark Figgie, orthopaedic surgeon at the Hospital for Special Surgery
in New York, told Reuters Health in a phone interview.
Figgie and colleagues reported their observations March 12 at the
American Academy of Orthopaedic Surgeons (AAOS) annual meeting in
Las Vegas.
Using a national insurance database, they compared early
complication rates and reoperations in seven age groups, from
younger than age 40 up to age 90 and older. The analysis included
114,698 patients having knee replacement surgery for the first time.
Diabetes, inflammatory arthritis, smoking and drug abuse were all
more common in patients under age 40, compared to the rest of the
patients.
After everyone's medical problems had been taken into account,
patients younger than 40 and those ages 40 to 49 had almost three
times the risk of early mechanical complications as everyone else.
People under age 40 were also 63 percent more likely than other
patients to need rehospitalization within 90 days.
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In addition, patients under age 40 were more apt to need revision
surgery within five years.
"These outcomes may be used to shape preoperative counseling for the
young patient," the investigators suggest.
"The younger patients tend have more challenging problems. They are
heavier, more diabetics, more inflammatory arthritis, more failed
ACL reconstructions," Figgie commented.
"Younger patients didn't have a higher infection rate," he noted.
"Mechanical problems and early failure were the biggest issues."
SOURCE: http://bit.ly/2tZUoLC American Academy of Orthopaedic
Surgeons 2019.
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