A review of total joint replacement in active duty soldiers

Thirty-two active duty soldiers (36 total joint replacements) were followed from 9 months and 18 years (average 4.1 years) to evaluate the outcome of total joint replacement in active duty soldiers. Follow-up consisted of clinical assessment and radiographic evaluation at 6 weeks, 3 months, 6 months, 1 year, and yearly thereafter. A Harris hip rating (HHR) was also completed at each clinic visit. There were 30 total hip arthroplasties in 27 patients with an average age at surgery of 40.8 years (range 31-58) and an average follow-up of 4.1 years. The HHR averaged 93 on latest evaluation. There were three revisions (average 7.2 years). Of the 27 patients, 18 were retained on active duty and 9 were separated from service. Of the senior enlisted (E7 or above) and officers (O4 or above), 16 of 17 (94%) were retained on active duty, whereas only 2 of 10 (20%) of the junior enlisted (E6 or below) were retained on active duty. There were 6 total knee arthroplasties in 5 patients with an average age at surgery of 49.8 years (range 33-58) and an average follow-up of 3.0 years (9 months to 4 years). There were no revisions, and all 5 soldiers were retained on active duty. Preliminary results from this study reveal that a high percentage of soldiers undergoing total joint replacement are retained on active duty (72%) and are able to continue active lives. Rank or seniority also appears to be a significant factor for retention on active duty. The revision rate (10%) and the rate of osteolysis (19%) are comparable with reported rates.