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Surgery for knee osteoarthritis in younger patients.

W-Dahl, Annette LU ; Robertsson, Otto LU and Lidgren, Lars LU (2010) In Acta Orthopaedica 81(2). p.161-164
Abstract
Background and purpose In Sweden, surgery for knee osteoarthritis (OA) in patients younger than 55 years of age has doubled during the last 10 years. We evaluated the use of 3 surgical alternatives: high tibial osteotomy (HTO), unicompartmental arthroplasty (UKA), and total knee arthroplasty (TKA). We also examined the outcome, expressed by rate of revision. Methods The numbers of all procedures during 1998-2007 were obtained from the Swedish Knee Arthroplasty Register (SKAR) (UKA < 55 years: n = 1,050; UKA >/= 55 years: n = 7,743; TKA < 55 years: n = 2,832; TKA >/= 55 years: n = 62,829) and the National Board of Health and Welfare (NHW) (HTO 25-55 years: n = 2,266). The revision rate (presented as life tables) was based on the... (More)
Background and purpose In Sweden, surgery for knee osteoarthritis (OA) in patients younger than 55 years of age has doubled during the last 10 years. We evaluated the use of 3 surgical alternatives: high tibial osteotomy (HTO), unicompartmental arthroplasty (UKA), and total knee arthroplasty (TKA). We also examined the outcome, expressed by rate of revision. Methods The numbers of all procedures during 1998-2007 were obtained from the Swedish Knee Arthroplasty Register (SKAR) (UKA < 55 years: n = 1,050; UKA >/= 55 years: n = 7,743; TKA < 55 years: n = 2,832; TKA >/= 55 years: n = 62,829) and the National Board of Health and Welfare (NHW) (HTO 25-55 years: n = 2,266). The revision rate (presented as life tables) was based on the SKAR material for arthroplasties. For HTOs, a single institutional series of 450 patients aged 30-64 years was used to calculate the revision rate and to compare it to that for UKAs (n = 4,799; age 30-64 years). Results During the 10 years, the use of TKA in patients younger than 55 years increased fivefold. While UKA increased threefold, its use diminished in the last 2 years. Although the use of HTO halved during the period, it is still used more often than UKA. The risk of revision increased in patients younger than 55 years and was lower for TKA (9%) than for UKA (24%). The revision rate was similar for HTO (17%) and for UKA (17%) in patients aged 30-64 years. Interpretation TKA is the preferred method for young OA patients in Sweden today. The use of HTO and UKA has diminished, and as the few operations are spread over many hospitals, there is a risk of gradual loss of experience with respect to patient selection and surgical routine-with a negative effect on outcome. Thus, there is a risk that these treatment alternatives for younger patients will eventually be abandoned. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
81
issue
2
pages
161 - 164
publisher
Taylor & Francis
external identifiers
  • wos:000276361700001
  • pmid:19968599
  • scopus:77950581665
ISSN
1745-3682
DOI
10.3109/17453670903413186
language
English
LU publication?
yes
id
01998384-5f68-4e6f-9e37-02f028cc6365 (old id 1523837)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19968599?dopt=Abstract
date added to LUP
2010-01-14 09:03:02
date last changed
2018-05-29 11:08:07
@article{01998384-5f68-4e6f-9e37-02f028cc6365,
  abstract     = {Background and purpose In Sweden, surgery for knee osteoarthritis (OA) in patients younger than 55 years of age has doubled during the last 10 years. We evaluated the use of 3 surgical alternatives: high tibial osteotomy (HTO), unicompartmental arthroplasty (UKA), and total knee arthroplasty (TKA). We also examined the outcome, expressed by rate of revision. Methods The numbers of all procedures during 1998-2007 were obtained from the Swedish Knee Arthroplasty Register (SKAR) (UKA &lt; 55 years: n = 1,050; UKA &gt;/= 55 years: n = 7,743; TKA &lt; 55 years: n = 2,832; TKA &gt;/= 55 years: n = 62,829) and the National Board of Health and Welfare (NHW) (HTO 25-55 years: n = 2,266). The revision rate (presented as life tables) was based on the SKAR material for arthroplasties. For HTOs, a single institutional series of 450 patients aged 30-64 years was used to calculate the revision rate and to compare it to that for UKAs (n = 4,799; age 30-64 years). Results During the 10 years, the use of TKA in patients younger than 55 years increased fivefold. While UKA increased threefold, its use diminished in the last 2 years. Although the use of HTO halved during the period, it is still used more often than UKA. The risk of revision increased in patients younger than 55 years and was lower for TKA (9%) than for UKA (24%). The revision rate was similar for HTO (17%) and for UKA (17%) in patients aged 30-64 years. Interpretation TKA is the preferred method for young OA patients in Sweden today. The use of HTO and UKA has diminished, and as the few operations are spread over many hospitals, there is a risk of gradual loss of experience with respect to patient selection and surgical routine-with a negative effect on outcome. Thus, there is a risk that these treatment alternatives for younger patients will eventually be abandoned.},
  author       = {W-Dahl, Annette and Robertsson, Otto and Lidgren, Lars},
  issn         = {1745-3682},
  language     = {eng},
  number       = {2},
  pages        = {161--164},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Surgery for knee osteoarthritis in younger patients.},
  url          = {http://dx.doi.org/10.3109/17453670903413186},
  volume       = {81},
  year         = {2010},
}