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Subsequent Total Joint Arthroplasty After Primary Total Knee or Hip Arthroplasty: A 40-Year Population-Based Study.

Abstract Despite the large increase in total hip arthroplasties and total knee arthroplasties, the incidence and prevalence of additional contralateral or ipsilateral joint arthroplasty are poorly understood. The purpose of this study was to determine the rate of additional joint arthroplasty after a primary total hip arthroplasty or total knee arthroplasty.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 28244910
OWN - NLM
STAT- MEDLINE
DA  - 20170228
DCOM- 20170308
LR  - 20170308
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 5
DP  - 2017 Mar 01
TI  - Subsequent Total Joint Arthroplasty After Primary Total Knee or Hip Arthroplasty:
      A 40-Year Population-Based Study.
PG  - 396-401
LID - 10.2106/JBJS.16.00499 [doi]
AB  - BACKGROUND: Despite the large increase in total hip arthroplasties and total knee
      arthroplasties, the incidence and prevalence of additional contralateral or
      ipsilateral joint arthroplasty are poorly understood. The purpose of this study
      was to determine the rate of additional joint arthroplasty after a primary total 
      hip arthroplasty or total knee arthroplasty. METHODS: This historical cohort
      study identified population-based cohorts of patients who underwent primary total
      hip arthroplasty (n = 1,933) or total knee arthroplasty (n = 2,139) between 1969 
      and 2008. Patients underwent passive follow-up through their medical records
      beginning with the primary total hip arthroplasty or total knee arthroplasty. We 
      assessed the likelihood of undergoing a subsequent total joint arthroplasty,
      including simultaneous and staged bilateral procedures. Age, sex, and calendar
      year were evaluated as potential predictors of subsequent arthroplasty. RESULTS: 
      During a mean follow-up of 12 years after an initial total hip arthroplasty, we
      observed 422 contralateral total hip arthroplasties (29% at 20 years), 76
      contralateral total knee arthroplasties (6% at 10 years), and 32 ipsilateral
      total knee arthroplasties (2% at 20 years). Younger age was a significant
      predictor of contralateral total hip arthroplasty (p < 0.0001), but not a
      predictor of the subsequent risk of total knee arthroplasty. During a mean
      follow-up of 11 years after an initial total knee arthroplasty, we observed 809
      contralateral total knee arthroplasties (45% at 20 years), 31 contralateral total
      hip arthroplasties (3% at 20 years), and 29 ipsilateral total hip arthroplasties 
      (2% at 20 years). Older age was a significant predictor of ipsilateral or
      contralateral total hip arthroplasty (p < 0.001). CONCLUSIONS: Patients
      undergoing total hip arthroplasty or total knee arthroplasty can be informed of a
      30% to 45% chance of a surgical procedure in a contralateral cognate joint and
      about a 5% chance of a surgical procedure in noncognate joints within 20 years of
      initial arthroplasty. Increased risk of contralateral total knee arthroplasty
      following an initial total hip arthroplasty may be due to gait changes prior to
      and/or following total hip arthroplasty. The higher prevalence of bilateral total
      hip arthroplasty in younger patients may result from bilateral disease processes 
      that selectively affect the young hip, such as osteonecrosis, or structural hip
      problems, such as acetabular dysplasia or femoroacetabular impingement. LEVEL OF 
      EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete
      description of levels of evidence.
FAU - Sanders, Thomas L
AU  - Sanders TL
AD  - 1Departments of Orthopedic Surgery (T.L.S., H.M.K., and D.J.B.) and Health
      Sciences Research (H.M.K., C.D.S., and D.R.L.), Mayo Clinic, Rochester,
      Minnesota.
FAU - Maradit Kremers, Hilal
AU  - Maradit Kremers H
FAU - Schleck, Cathy D
AU  - Schleck CD
FAU - Larson, Dirk R
AU  - Larson DR
FAU - Berry, Daniel J
AU  - Berry DJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - AIM
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Hip/*statistics & numerical data
MH  - Arthroplasty, Replacement, Knee/*statistics & numerical data
MH  - Cohort Studies
MH  - Female
MH  - Hip Joint/*surgery
MH  - Humans
MH  - Knee Joint/*surgery
MH  - Male
MH  - Minnesota/epidemiology
MH  - Osteoarthritis/*epidemiology/*surgery
EDAT- 2017/03/01 06:00
MHDA- 2017/03/09 06:00
CRDT- 2017/03/01 06:00
AID - 10.2106/JBJS.16.00499 [doi]
AID - 00004623-201703010-00005 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Mar 1;99(5):396-401. doi: 10.2106/JBJS.16.00499.

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