Retrospective review of 114 cemented posterior-stabilized TKAs in 88 patients aged ≤55 (average 51) performed between 1977 and 1992. The study asks whether TKA delivers durable clinical, radiographic, and functional results — including return to activity — in younger patients with osteoarthritis or post-traumatic osteoarthritis. Mean follow-up was 8 years; 36 knees were followed beyond 10 years.
For decades, TKA was routinely withheld from patients under 60 out of concern that younger, more active patients would wear out implants and require multiple revisions over a lifetime.
This series challenged that assumption directly. When you see a patient under 55 with end-stage multicompartmental OA who has failed non-operative treatment, this paper supports offering cemented posterior-stabilized TKA — the 18-year survival data is as good as any published series in older patients.
Two technical points carry forward into current practice: avoid polyethylene spacers thinner than 10 mm, and never use carbon-fiber-reinforced polyethylene (accelerated wear, now abandoned). The conforming posterior-stabilized geometry reduces contact stress compared to flat-on-flat designs. A biomechanical rationale that still informs implant selection.
One nuance worth knowing: the authors caution that results came from two high-volume specialists, and that impact sports should still be discouraged. Not because loosening was observed here, but because longer follow-up could change that picture.
Retrospective review of 114 cemented posterior-stabilized TKAs in 88 patients aged ≤55 (average 51) performed between 1977 and 1992. The study asks whether TKA delivers durable clinical, radiographic, and functional results — including return to activity — in younger patients with osteoarthritis or post-traumatic osteoarthritis. Mean follow-up was 8 years; 36 knees were followed beyond 10 years.
For decades, TKA was routinely withheld from patients under 60 out of concern that younger, more active patients would wear out implants and require multiple revisions over a lifetime.
This series challenged that assumption directly. When you see a patient under 55 with end-stage multicompartmental OA who has failed non-operative treatment, this paper supports offering cemented posterior-stabilized TKA — the 18-year survival data is as good as any published series in older patients.
Two technical points carry forward into current practice: avoid polyethylene spacers thinner than 10 mm, and never use carbon-fiber-reinforced polyethylene (accelerated wear, now abandoned). The conforming posterior-stabilized geometry reduces contact stress compared to flat-on-flat designs. A biomechanical rationale that still informs implant selection.
One nuance worth knowing: the authors caution that results came from two high-volume specialists, and that impact sports should still be discouraged. Not because loosening was observed here, but because longer follow-up could change that picture.