Total knee arthroplasty in patients 40 years of age and younger with osteoarthritis

The results of 32 total knee arthroplasties performed for osteoarthritis in 32 patients who were 40 years of age or younger are reviewed. At a mean fo llowup of 7.9 years (minimum, 5 years), the Knee Society knee scores increa sed from an average of 47 to 88 points, and the function scores increased f rom 45 to 70 points. Overall, Knee Society knee scores were considered good or excellent in 82% of patients (26 knees) and fair or poor in 18% (six kn ees). Postoperative function scores were good or excellent in only 40% (13 knees). The average postoperative flexion are was 110 degrees, If patients involved in worker's compensation cases are excluded from analysis, the res ults improved substantially, with range of motion averaging 113 degrees, an d Knee Society knee scores and function scores averaging 92 points and 77 p oints, respectively. Excluding the five patients involved in workmen's comp ensation cases, knee scores were good or excellent in 91% of patients (25 k nees) and function scores were good or excellent in 50% of patients (14 kne es). Three revisions were performed for aseptic failure; one additional pat ient has radiographic evidence of tibial loosening, representing an aseptic failure rate of 12.5% at 8 years. Although slightly higher than observed i n older patients, this failure rate still mag be considered acceptable for this population of patients with severely affected knees who are not consid ered candidates for nonarthroplasty surgery. Despite a slightly higher tend ency for aseptic failures in this group of patients, cemented total knee ar throplasty may provide some patients younger than 40 years of age with seve re debilitating and recalcitrant osteoarthrosis, an important option with r easonable mid- and long-term results.