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Table 3 Results for revision rate

From: Is there an optimal age for total knee arthroplasty?: A systematic review

Author Journal Year Age (years) Number Result
Difference
 Jorgensen [24] J Bone Joint Surg Am 2019 < 55,
55–64,
65–74,
≥ 75
478,081 The MAR at 15 years was 3.0% (2.8–3.2%). Age had a significant effect on MAR rates, with cumulative percent revision at 15 years for patients < 55 years old of 7.8% (95% CI, 6.5% to 9.2%) compared with 1.0% for those ≥ 75 years old (95% CI, 0.8% to 1.1%; P < 0.001).
 Bayliss [30] Lancet 2017 50–54,
55–59,
60–64,
65–69,
70–74,
75–79,
80–84,
≥85
54,276 For patients aged 70 years at implantation (mean age of implantation) LTRR was between 4·4% and 7·7%. For patients aged between 60 and 70 years, LTRR increased with decreasing age, reaching approximately 15% for both hip and knee replacement at 60 years, with greater risk in male than in female patients. Significant increase in LTRR was seen in younger men, with values 35.0% (30.9–39.1) seen in the youngest patient group (50–54 years)
 Shin [41] BMC Musculoskelet Disord 2015 < 65,
65–74,
≥ 75
260,068 The overall incidence rate of revision TKA was 367.3/100,000 person-years. The incidence in patients 50 years old or younger was extremely high. Incidence rate per 100,000 person-years: < 65 years (447.2), 65–74 years (363.7), ≥ 75 years (270.9)
 Callaghan [38] Clin Orthop Rel Res 2015 < 65,
≥ 65
220 Overall patient survivorship to 20-year follow up was only 26%. Patient survivorship at 20-year follow up was significantly higher in patients < 65 years of age in both cohorts (54% versus 15%, P < 0.001 modular tray cohort, and 52% versus 26%, P = 0.002 rotating platform cohort).
 Meehan [45] J Bone Joint Surg Am 2014 < 50,
50–64,
≥ 65
120,538 The risk of aseptic mechanical failure was 4.7 times higher (OR = 4.66, 95% CI, 3.77 to 5.76) in patients younger than 50 years of age, 2.1 times higher (OR = 2.09, 90% CI, 1.81–2.41) in patients 50–64 years compared with patients 65 years of age or older
 Namba [49] J Arthroplast 2013 < 65,
≥ 65
64,017 There was a significantly different revision rate (P < 0.001) in the < 65 and ≥ 65 years age groups. For every 10-year increase in age the risk of revision decreases by 38% (95% CI, 33%–43%, P < 0.001).
 Wainwright [55] Bone Joint J 2011 < 50,
50–59,
60–75,
≥ 75
1538 Patients younger than 50 years at the time of surgery have a greater chance of requiring revision than of dying, those around 58 years of age have a 50:50 chance of needing revision, and in those older than 62 years the prosthesis will normally outlast the patient.
Julin [56] Acta Orthop 2010 ≤ 55,
56–65,
> 65
32,019 The 5-year survival rates were 92% and 95% in patients age ≤ 55 and 56–65 years, compared to 97% in patients who were > 65 years of age (P < 0.001) Overall risk of prosthesis failure > 3.7 years follow up: ≤ 55 years (5.0 [3.2–8.0]), 55–65 years (2.0 [1.4–2.9]) vs. > 65 years
No difference
 Lizaur-Utrilla [35] Knee Surg Sport Traumatol Arthrosc 2016 ≤ 55: 61
60–70: 61
≤ 55, 60–70 No significant relationship between revision and age younger than 55 and older than 55 years
  1. CI confidence interval, OR odds ratio, SD standard deviation, MAR major aseptic revision, LTRR lifetime risk of revision