Younger patients have greater need for total knee arthroplasty

Younger individuals have greater need for total knee arthroplasty (TKA) and are as willing to undergo surgery as older individuals, according to a study published online Feb. 28 in the Journal of Bone & Joint Surgery.

Gillian A. Hawker, M.D., from the University of Toronto, and colleagues examined the association between patient age and TKA appropriateness and receipt of a TKA recommendation among knee osteoarthritis patients referred for TKA from 2014 to 2016.

• The researchers found that 3.3 and 22.7% of the 2,037 participants were aged younger than 50 years and 50 to 59 years, respectively.
• Younger participants reported significantly worse knee symptoms, higher use of osteoarthritis therapies, and higher TKA readiness than older participants, and they had similar willingness to undergo surgery.
• Younger participants had higher body mass index, were more likely to smoke, and were more likely to consider the ability to participate in vigorous activities as a very important TKA outcome.
• Overall, 73.6% of participants were offered TKA (52.2, 71.0, and 75.4% of those aged younger than 50, 50 to 59, and 60 years or older, respectively).
• The odds of receiving a TKA recommendation were increased with greater need and willingness for TKA, for nonsmokers, and in those for whom improved ability to go upstairs and to straighten the leg were very important TKA outcomes.
• There was no association for patient age with TKA recommendation after controlling for TKA appropriateness.

"Surgeons were not more likely to recommend TKA to younger versus older participants," the authors write. "These findings indicate trends reflecting increasing need/demand for TKA among younger individuals at potentially higher risk for TKA complications."

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