J Korean Med Sci.  2024 Mar;39(11):e106. 10.3346/jkms.2024.39.e106.

Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population

• Kim S
• Won SJ
• Lee NK
• Chang CB

• KMID: 2554204
• DOI: http://doi.org/10.3346/jkms.2024.39.e106

Abstract

Background
This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA.
Methods
Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death.
Results
The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA.
Conclusion
TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA.

Keyword

Total Knee Arthroplasty; Long-Term Mortality; Cause of Death; Standardized Mortality Ratio; Risk Factor

Figure

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  Fig. 1 Flow diagram of retrospective cohort study.TKA = total knee arthroplasty.

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  Fig. 2 Kaplan-Meier survival curve for all study subjects.

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  Fig. 3 Kaplan-Meier survival curves by group. (A) Comparison by gender; (B) Comparison by age groups; (C) Comparison by BMI.BMI = body mass index.

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