Elsevier

The Journal of Arthroplasty

Volume 28, Issue 10, December 2013, Pages 1842-1845
The Journal of Arthroplasty

The Fate of the Remaining Knee(s) or Hip(s) in Osteoarthritic Patients Undergoing a Primary TKA or THA

https://doi.org/10.1016/j.arth.2012.10.008Get rights and content

Abstract

The purpose of this study was to determine the fate of the remaining hip(s) and knee(s) following an initial total hip or knee arthroplasty in 5352 patients with idiopathic osteoarthritis who were followed for a minimum ten years (mean 17.8 ± 5.7 years). Following an initial primary TKA, 46.0% of patients had a contralateral TKA, 2.3% had an ipsilateral THA and 1.3% had a contralateral THA. Following an initial primary THA, 30.5% of patients had a contralateral THA, 6.8% had an ipsilateral TKA and 2.9% had a contralateral TKA. Cox regression analysis demonstrated that BMI was the sole risk factor for a second THA, but both age less than sixty years and a higher BMI were significant factors for patients requiring an additional primary TKA.

Section snippets

Materials and Methods

In 1987, with institutional review board approval, a prospective total hip and knee arthroplasty database was established which captured pre-operative, intra-operative and postoperative data on all patients who had a total knee or hip arthroplasty performed in our hospital. With additional institutional review board approval, this database was utilized to identify all osteoarthritic patients who received a primary hip or knee arthroplasty more than ten years ago. Patients were excluded if their

Results

There were 5352 osteoarthritic patients identified in our institutional database who had a primary total hip or knee arthroplasty performed as their first lower extremity total joint arthroplasty and had ten or more years of follow-up. All procedures were done between January, 1987 and December, 2000. The mean patient follow-up was 17.8 ± 5.7 years (range 10–23 years). Of these patients, 2917 (54.5%) received a total knee arthroplasty and 2435 (45.5%) received a total hip arthroplasty (Fig. 1).

Discussion

This study represents the largest reported cohort of patients with a diagnosis of osteoarthritis who were followed for a minimum of ten years (mean 17.8 ± 5.7 years) to determine the fate of the remaining hip and knee joints after an initial primary THA or TKA. Using the need for a subsequent total hip or knee arthroplasty in one of the remaining hip or knees as a surrogate for the development of end-stage osteoarthritis, we found that the joint arthroplasty was often needed in these remaining

Acknowledgments

We thank Dr. Cecil Rorabeck, MD, FRCS for his contributions to this study.

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest with the submitted article. All the authors confirm that we have full control of all primary data and we agree to allow the journal to review our data if requested.

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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2012.10.008.

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Co-first author: Yunchao Shao, MD, Chi Zhang, MD.

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