Here’s a question I’m often asked by patients: “If one of my joints has worn out, how likely are the others to go?” A recent publication from the Osteoarthritis Initiative (OAI) lends some insights into this question. The study, found in the Aug. 12, 2019 issue of Clinical Orthopaedics and Related Research, is the first of its kind. The likelihood of undergoing a 2nd Arthroplasty (Joint replacement) after hip or knee replacement had not previously been evaluated.
The authors prospectively asked two questions: “What is the likelihood of second Total Knee Arthroplasty (TKA) or Total Hip Arthroplasty (THA) after primary TKA or THA?” and “What risk factors are associated with undergoing addition joint replacement. The study identified 332 patients who underwent primary TKA and another 132 who underwent THA across five OAI-participating centers in the U.S., who hadn’t previously had a THA or TKA. The patients were followed for 8 years after their primary joint replacement.
- The incidence of contralateral (opposite Knee) TKA after primary TKA was 40%
- The incidence of THA after any TKA was 13%
- The incidence of contralateral (opposite) THA after primary THA was 8%
- The incidence of any TKA after primary THA was 32%
As for the second question in the study: Risk factors for undergoing contralateral TKA were younger age and a loss of medial joint space with a varus angulation, or bow leg deformity.
The conclusion is clear: Patients who underwent TKA or THA for osteoarthritis had a relatively high rate of subsequent joint arthroplasty. There’s no question that osteoarthritis is common and debilitating, and often it affects more than one large, weight-bearing joint.
If you need a joint replacement or want to learn more about the procedure, hip or knee replacement surgical outcomes, recovery and quality-of-life prognosis, please contact our office. We’ll help you return to your healthy, pain-free lifestyle. Dr. Stickney, a Kirkland orthopedic surgeon, is a knee and hip expert specializing in joint replacement surgery.
With outpatient (same-day discharge) hip and knee replacement procedures becoming more common, it’s crucial to keep up with the latest research. In a recent article published by Journal of Bone & Joint Surgery, Authors Basques, Tetreault and Della Valle conduct a cohort study taking a look at patients who underwent outpatient joint replacement compared to patients who underwent inpatient joint replacement.
The authors researched 177,818 patients who underwent primary elective total hip arthroplasty, total knee arthroplasty or unicompartmental knee arthroplasty from 2005-2014. They found no significant differences in overall postoperative complications or readmission between the inpatient and outpatient procedures, though the study did find that inpatients did have a higher rate of thromboembolic events (blood clots in the legs) and outpatients had a higher rate of reoperation. The researchers also noted that patients with elevated body mass index, (overweight) diabetes and an age over 85 years had an increased risk of readmission rate following outpatient surgery.
In another recent study published by Journal of Bone & Joint Surgery, authors Arshi et al. take a look at the nationwide trends and risks associated with outpatient total knee replacement. The study is a retrospective review of patients who had undergone total knee arthroplasty as either inpatients or outpatients from 2007-2015. The data demonstrated a higher risk of perioperative complications including component failure, surgical site infection, knee stiffness and deep vein thrombosis for outpatients.
This research may seem a bit conflicting, but in the end, it highlights the importance of being in good health before considering outpatient joint replacement surgery. Outpatient joint replacement can be a very successful, cost-saving option, but your orthopedic surgeon should only recommend it if you meet certain health requirements. We work with our patients through all stages of joint replacement to ensure they enjoy a quick, pain-free procedure and recovery and can get back to their healthy lifestyle as soon as possible.
Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in joint replacement surgery, sports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!