Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register
Background and purpose — Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Pat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2017-05-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2017.1290479 |
| _version_ | 1798017969047994368 |
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| author | Anders El-Galaly Steffen Haldrup Alma Becic Pedersen Andreas Kappel Michael Ulrich Jensen Poul Torben Nielsen |
| author_facet | Anders El-Galaly Steffen Haldrup Alma Becic Pedersen Andreas Kappel Michael Ulrich Jensen Poul Torben Nielsen |
| author_sort | Anders El-Galaly |
| collection | DOAJ |
| description | Background and purpose — Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Patients and methods — 52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA). Short-term (< 1 year), medium-term (1–5 years), and long-term (> 5 years) implant survival were analyzed using Kaplan-Meier analysis and Cox regression after age stratification (< 50, 50–70, and >70 years). In addition, indications for revision and characteristics of TKA patients with subsequent revision were determined. Results — During the first 5 years, TKAs inserted due to PTFA had a higher risk of revision than OA (with adjusted hazard ratio ranging from 1.5 to 2.4 between age categories). After 5 years, no significant differences in the risk of revision were seen between the groups. Infection and aseptic loosening were the most common causes of revision in both groups, but TKA instability was a more frequent indication for revision in the PTFA group. In both groups, the revision rates were higher with younger age and extended duration of primary surgery. Interpretation — We found an increased risk of early and medium-term revision of TKAs inserted due to previous fractures in the distal femur and/or proximal tibia. Predictors of revision such as age <50 years and extended duration of primary surgery were identified, and revision due to instability occurred more frequently in TKAs performed due to previous fractures. |
| first_indexed | 2024-04-11T16:16:16Z |
| format | Article |
| id | doaj.art-294506fedb91478e997455e860f5e643 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:16:16Z |
| publishDate | 2017-05-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-294506fedb91478e997455e860f5e6432022-12-22T04:14:32ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822017-05-0188326326810.1080/17453674.2017.12904791290479Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty RegisterAnders El-Galaly0Steffen Haldrup1Alma Becic Pedersen2Andreas Kappel3Michael Ulrich Jensen4Poul Torben Nielsen5Aalborg University HospitalAarhus UniversityAarhus University HospitalAalborg University HospitalAalborg University HospitalAalborg University HospitalBackground and purpose — Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Patients and methods — 52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA). Short-term (< 1 year), medium-term (1–5 years), and long-term (> 5 years) implant survival were analyzed using Kaplan-Meier analysis and Cox regression after age stratification (< 50, 50–70, and >70 years). In addition, indications for revision and characteristics of TKA patients with subsequent revision were determined. Results — During the first 5 years, TKAs inserted due to PTFA had a higher risk of revision than OA (with adjusted hazard ratio ranging from 1.5 to 2.4 between age categories). After 5 years, no significant differences in the risk of revision were seen between the groups. Infection and aseptic loosening were the most common causes of revision in both groups, but TKA instability was a more frequent indication for revision in the PTFA group. In both groups, the revision rates were higher with younger age and extended duration of primary surgery. Interpretation — We found an increased risk of early and medium-term revision of TKAs inserted due to previous fractures in the distal femur and/or proximal tibia. Predictors of revision such as age <50 years and extended duration of primary surgery were identified, and revision due to instability occurred more frequently in TKAs performed due to previous fractures.http://dx.doi.org/10.1080/17453674.2017.1290479 |
| spellingShingle | Anders El-Galaly Steffen Haldrup Alma Becic Pedersen Andreas Kappel Michael Ulrich Jensen Poul Torben Nielsen Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register Acta Orthopaedica |
| title | Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register |
| title_full | Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register |
| title_fullStr | Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register |
| title_full_unstemmed | Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register |
| title_short | Increased risk of early and medium-term revision after post-fracture total knee arthroplasty: Results from the Danish Knee Arthroplasty Register |
| title_sort | increased risk of early and medium term revision after post fracture total knee arthroplasty results from the danish knee arthroplasty register |
| url | http://dx.doi.org/10.1080/17453674.2017.1290479 |
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