William Long and colleagues at the Hospital for Specialized Surgery in New York City analyzed 40-year outcomes of total knee replacements in patients aged 33 and older and found that lifetime revision surgery was unlikely. Eighty-one patients aged 33 to 55 years received 107 Insall-Burstein I or Insall-Burstein II knee replacements (predecessors to today's models) between 1977 and 1992. The results were presented at the 2025 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) and reported in a HSS press release.
70 percent of the participants did not experience the need for surgical revision of the prosthetic joint during their subsequent life. The probability of death was 3-4 times higher than the need for re-operation. Also, after the intervention, the patients' physical activity significantly increased: on average, from 1.5 to 2.7 points on the TAS scale. Long noted that most of the causes of surgical revisions identified in the work have been eliminated in modern models of prostheses, so that when they are used even at a young age, they are most likely to last a lifetime.
