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J Knee Surg 2024; 37(06): 452-459
DOI: 10.1055/a-2176-4688
Original Article

Impacts of Knee Arthroplasty on Activity Level and Knee Function in Young Patients: A Systematic Review

Jonathan Williams
1   Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
3   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
João B. de Albuquerque II
1   Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
3   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
Clayton W. Nuelle
1   Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
2   Department of Orthopaedic Surgery, Mizzou Joint and Limb Preservation Center, Missouri Orthopaedic Institute, Columbia, Missouri
3   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
James P. Stannard 
1   Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
2   Department of Orthopaedic Surgery, Mizzou Joint and Limb Preservation Center, Missouri Orthopaedic Institute, Columbia, Missouri
3   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
James L. Cook 
1   Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
2   Department of Orthopaedic Surgery, Mizzou Joint and Limb Preservation Center, Missouri Orthopaedic Institute, Columbia, Missouri
3   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
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Abstract

The annual demand for knee arthroplasty has been steadily rising, particularly in younger patients. The primary objective of this systematic review was to determine the impact of knee arthroplasties on knee function and activity levels in young (≤55 years) patients. A PubMed search from inception (1977) to March 2022 to identify eligible studies produced 640 peer-reviewed studies for consideration. A total of 18 studies including 4,186 knee arthroplasties in 3,200 patients (mean patient age at the time of surgery: 47.4 years, range: 18–55 years) were ultimately included for analysis. Mean final follow-up (FFU) duration was 5.8 years (range: 2–25.1 years). Mean FFU improvement in Knee Society Clinical Score was 48.0 (1,625 knees, range: 20.9–69.0), Knee Society Function Score was 37.4 (1,284 knees, range: 20–65). Mean FFU for the Tegner and Lysholm activity scale was 2.8 (4 studies, 548 knees, range: 0.7–4.2); University of California Los Angeles Physical Activity Questionnaire score was 2.8 (3 studies, 387 knees, range: 1.2–5); lower extremity activity scale was 1.84 (529 knees). The available evidence suggest that young patients typically realize sustained improvements in knee function compared to preoperative levels; however, these improvements do not typically translate into a return to desired activity levels or quality of life, and this patient population should expect a higher and earlier risk for revision than their older counterparts. Further research, including robust registry data, is needed to establish evidence-based indications, expectations, and prognoses for outcomes after knee arthroplasty in young and active patients.

Keywords

knee arthroplasty - patient-reported outcomes - activity level - systematic review


Publication History

Received: 12 June 2023

Accepted: 14 September 2023

Accepted Manuscript online:
15 September 2023

Article published online:
12 October 2023

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