Total knee arthroplasty survival rates are lower in younger men,as well as rheumatoid patients and after previous high-tibial osteotomy: A registry study.

Abstract

The purpose of this study was to investigate if patient's gender significantly affected the long-term outcome of patients undergoing total knee arthroplasty (TKA) and to provide a cross-gender comparison of a large patient sample from a single regional register. The Registry of Prosthetic Orthopedic Implant of Emilia Romagna (RIPO) investigated all primary TKAs performed from July 2000 to December 2020 by collecting data of menand womenseparately. Primary bicompartmental and tricompartmental TKAs were included. The survival rates and the reasons for revision were assessed to check if any other factor could have influenced implantfailure. In total,66,032 TKAs were included and analysed, comprising 46,774 women and 19,258 men. The 15-year Kaplan-Meier survival percentage was 93.6% for womenand 92.5% formen (p = 0.001). Men exhibited a higher revision risk following primary TKA(p = 0.012), particularly when the primary diagnosis was arthritis resulting from rheumatic disorders (p = 0.018) and arthritis following high-tibial osteotomy (p = 0.024). Failure risk was also higher for men below the age of 60 years(p = 0.038). The long-term outcome in TKA showed significant differences between men and women, with a significantly lower survival rate in men at 15 years, especially when they areunder 60 years old or with a diagnosis of rheumatic disorders or arthritis following high-tibial osteotomy. It is necessary to design specific studies to have relevant data concerning gender differences in prosthetic surgery and to customise treatments to improve outcome and patient satisfaction. Level III.