Total knee replacement (TKR) in people suffering from juvenile idiopathic arthritis (JIA) results in better quality of life over the long term. However, further research will be needed to establish why implant longevity is poorer than in elderly osteoarthritic patients and to find ways of improving implant survivorship in JIA patients.
These are the findings of a study conducted by a research team from the New York-based Hospital for Special Surgery (HSS). Led by Dr Mark P. Figgie, the HSS researchers concentrated on the outcomes of 294 TKR surgeries undertaken at five hospitals between 1979 and 2011. Dr Figgie said that joint replacement was a way of giving JIA patients a life free of unrelenting pain. In many cases, these are people still in their adolescence and surgery can change their lives.
The study established that 49% of the subjects were able to cover an unlimited distance on foot and 22% were able to walk five to ten blocks. When it came to climbing stairs, 59% did so with support from the railing, while 11% were unable to climb stairs. A cane was used by 11.7% and the same proportion needed a wheelchair.
A matter of serious concern for the researchers is the lower knee implant survivorship in JIA patients. In the case of elderly osteoarthritic patients, approximately 90% of TKRs are good to go for between 15 and 20 years. The ten-year survival rate of TKRs among JIA patients was 92.2% but the 20-year rate was estimated at slightly over 75%.