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In terms of available implants, "in straightforward cases, the choice of one design over another is largely a matter of surgeon preference," they write.

After reviewing several studies on the outcomes of knee replacements, the authors find "excellent long-term success" with most of the studies showing well over 90% survivorship at periods ranging from 10 to 16 years and annual failure rates significantly under 1%.

Newer implants include "cementless" implants, which show promising results and may become particularly beneficial for younger patients. A lot of research is now being directed at improving these implants for younger, more active patients, the authors report.

The new findings also bring good news for younger people with severe knee arthritis who may need replacement surgery, Spitzer says. "The younger arthritic patient (aged 55 or under) has traditionally represented a frustrating dilemma for the knee surgeon, but recent literature supports the decision to proceed with arthroplasty when end-stage disease is identified," the authors report.

"This new article really tells us where things are at in the world of knee replacement," Ronald P. Grelsamer, MD, chief of hip and knee surgery at Maimonides Medical Center in Brooklyn and an attending orthopaedic surgeon at the Hospital for Joint Diseases in New York, tells WebMD. "There are a number of available knee implants with reasonable track records, and my advice is to go to a surgeon who uses an implant that has been around for a long time as those are the ones with the most evidence supporting their use."

Vital Information:

  • For patients with severe knee arthritis, orthopaedic surgeons have made great advances in total knee replacement surgery, with an annual failure rate significantly less than 1%.
  • The surgery involves resurfacing the kneecap and putting in an implant made of steel and plastic.
  • Researchers report that procedure can even be recommended for younger patients with severe knee arthritis, a group to which physicians are sometimes hesitant to advise surgery.

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