"Rapid Growth" of Knee Replacement in Younger Patients
BY LAUREN UZDIENSKI, JANUARY 17, 2012
Researchers in Finland have identified a 130-fold increase in incidence of total knee arthroplasty among Finnish patients younger than 59 years of age between 1980 and 2006. These data help to quantify the trend of younger patients undergoing knee replacement procedures while illustrating the need for more data on the long-term durability of knee devices.
The population-based study found that knee-replacement incidence increased from 0.5 to 65 operations per 100,000 individuals between the ages of 30 and 59. The most rapid increase was observed from 2001 to 2006, during which time the rate climbed from 18 to 65 operations per 100,000. More women than men were undergoing surgery, with the authors noting that the incidence of TKA was 1.6 to 2.4-fold higher in women. The adoption of new knee technologies was also reflected in the data, with the researchers noting an increase in incidence of partial knee replacements from 0.2 to 10 operations per 100,000 inhabitants by 2006. Patients were selected for surgery based on a diagnosis of knee OA.
While factors such as obesity have contributed to lowering the ages of patients undergoing knee replacement worldwide, most knee replacements were still performed in the Finnish study's oldest age group (50 to 59 years of age). The spike in knee procedures in Finland over the 27-year study period was not attributed to one particular factor, though the authors suggested that "some of the growth might be due to the increase of incidences observed in low and intermediate volume hospitals."
The authors also raised questions about the long-term outcomes associated with performing knee replacement procedures on younger patients. The study's lead author, Jarkko Leskinen, said that, "Given that younger patients may be at higher risk of artificial knee joint failure and thus in need of a second replacement surgery, long-term data are needed before widespread use of total knee arthroplasty is recommended for this patient population."
