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Joint Replacement Failure – Under 60’s

Joint Replacement Failure – Under 60’s

April 25,2018

Macquarie Stem Cells has provided this information to educate the public based on peer reviewed, published scientific and medical documents. We don’t aim to encourage consumers to seek out such treatments prior to an assessment by a health professional to determine your suitability for treatment. This is obtained directly from NCBI Pubmed Literature. This study was funded by Oxford Musculoskeletal Biomedical Research Unit, National Institute for Health Research. We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, this is discussed in ‘supporting information>other-options’  page on our website

Published: The Lancet – 2017

TITLE: “The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study.” (Bayliss et al., 2017)

The risk of joint replacement revisions based on the patients age, looking at knees and hips.

The text found below is a summary of the population based cohort study.

BACKGROUND:

“Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery.” (Bayliss et al., 2017)

METHODS:

“We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement. These data were adjusted for all-cause mortality with data from the Office for National Statistics and used to generate lifetime risks of revision surgery based on increasing age at the time of primary surgery.” (Bayliss et al., 2017)

FINDINGS:

“We identified 63 158 patients who had undergone total hip replacement and 54 276 who had total knee replacement between Jan 1, 1991, and Aug 10, 2011, and followed up these patients to a maximum of 20 years. For total hip replacement, 10-year implant survival rate was 95·6% (95% CI 95·3-95·9) and 20-year rate was 85·0% (83·2-86·6). For total knee replacement, 10-year implant survival rate was 96·1% (95·8-96·4), and 20-year implant survival rate was 89·7% (87·5-91·5). The lifetime risk of requiring revision surgery in patients who had total hip replacement or total knee replacement over the age of 70 years was about 5% with no difference between sexes. For those who had surgery younger than 70 years, however, the lifetime risk of revision increased for younger patients, up to 35% (95% CI 30·9-39·1) for men in their early 50s, with large differences seen between male and female patients (15% lower for women in same age group). The median time to revision for patients who had surgery younger than age 60 was 4·4 years.” (Bayliss et al., 2017)

INTERPRETATION:

“Our study used novel methodology to investigate and offer new insight into the importance of young age and risk of revision after total hip or knee replacement. Our evidence challenges the increasing trend for more total hip replacements and total knee replacements to be done in the younger patient group, and these data should be offered to patients as part of the shared decision making process.” (Bayliss et al., 2017)

Reference: Bayliss, L., Culliford, D., Monk, A., Glyn-Jones, S., Prieto-Alhambra, D., Judge, A., Cooper, C., Carr, A., Arden, N., Beard, D. and Price, A. (2017). The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. The Lancet, 389(10077), pp.1424-1430.Tags: Macquarie Stem Cells, Dr. Bright, Osteoarthritis Treatment, Dr. Ralph Bright, Biological Therapy,Biological Treatment, Treatment for Arthritis

Remember, any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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