Evaluating Long Term Outcomes and Survivorship of Cruciate Retaining and Sacrificing Knee Replacements Done for Degenerative Arthritis in Patients Under 55 Years

Abstract

Background: Total Knee Arthroplasty (TKA) is the gold standard of treatment for end stage arthritis not responding to conservative treatment. With a recent increase in the younger population presenting with osteoarthritis (OA) we undertook this study to evaluate long-term outcomes and survivorship of TKA in this cohort. Materials and Methods: Our study cohort included 328 patients, < 55 years, with OA, who underwent TKA using Cruciate Retaining (CR), and Posterior Stabilized (PS) implants with a minimum follow up of 15 years. Revision surgery was the end point of our analysis and Kaplan–Meier evaluation of survivorship was measured. Knee Society Scores (KSS) and Range of Motion (ROM) were assessed to evaluate outcomes. Results: Survivorship of the CR and PS implants with revision as end point, for aseptic loosening was 97.3% and 96%, and revision for all causes was 89.7% and 86.1%, respectively, at 15 years. The outcomes of CR implants were better than the PS cohort in terms of function and survivorship. Conclusion: Long term survivorship and outcome analysis of TKA in patients < 55 years showed good results with excellent survivorship, with both CR and PS implants. The CR cohort demonstrated better long-term survivorship, though the difference was not statistically significant. Deep infection and aseptic loosening were the commonest causes for failure. [Figure not available: see fulltext.].