How Long Does A Knee Replacement Last? A Systematic Review And Meta-analysis Of Case Series And National Registry Reports With More Than 15 Years Of Follow-up. Evans JT, Walker RW, Evans JP, Blom AW, Sayers A, Whitehouse MR. Lancet. 2019 Feb 16;393(10172):655-663.
Total knee replacements (TKR) are a common and effective treatment for severe knee osteoarthritis. Knee replacements can fail over time due to loosening, infection, persistent pain, or instability. It is not known how long knee replacements last. Knowing this information could be helpful in counseling our patients who are considering surgery.
These authors conducted a systematic review of the literature and reviewed registry data from Australia and Finland. The systematic review found 26 case series with reported “all cause survival” of the TKR in 6490 patients. Case series suffer from publication bias. The registry data provided much more robust numbers with 299,291 patients in 47 series.
Registry data shows 82% of TKRs last 25 years. 93% last 15 years.
An article by the same authors using the same methodology in the same issue of Lancet report registries show 58% of hip replacements last 25 years.
EDITOR'S COMMENTARY - Steve Brown MD This is pretty impressive data and a great use of a registry. These authors got 2 Lancet publications out of asking a brilliant question and finding the right method to answer the question. It’s not clear if this is generalizable to current patients. Has the technology changed?
BOTTOM LINE: 82% of total knee replacements and 58% of hip replacements will last 25 years.
J. B. L. - July 14, 2019 10:29 AM
Ken - I was also an athlete and also ate up all my cartilage- almost did the TKR but didn't in the last minute when I discovered that 15% of the operations fail inhte short term and most of these people never walk again. True this seems to be in older people ( I am only 59) but I was able to battle back through vigorous physiotherapy. Just be careful
Ken M. - July 15, 2019 7:21 AM
Thank you for sharing your experience. I am trying to manage the knee issue and put off the TKR as long as possible. Staying active is key to so many chronic issues.