Total knee arthroplasty in nonagenarians

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomedical Engineering

Background:

• Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
• Surgical outcomes in nonagenarians (patients aged 90 and above) are less understood.
• Assessing the efficacy and safety of TKA in this elderly demographic is crucial.

Purpose of the Study:

• To evaluate the clinical outcomes and complications of primary total knee arthroplasty (TKA) in patients aged 90 years or older.
• To assess the impact of TKA on pain, function, and quality of life in nonagenarian patients.

Main Methods:

• Retrospective review of 3714 primary TKAs performed between 1976 and 1999.
• Analysis of 20 TKAs performed in 18 patients aged 90 years or older.
• Follow-up averaged 62.2 months, assessing pain, knee scores (Knee Society clinical assessment scale), function, and complications.

Main Results:

• One postoperative death within 90 days occurred.
• All patients achieved complete pain relief and excellent knee scores.
• Moderate improvement in knee function was observed, with no patients achieving excellent function.
• One surgical complication (wound dehiscence) and medical complications in 26.3% of survivors were reported.
• Average hospital stay was 10.1 days.

Conclusions:

• Total knee arthroplasty (TKA) in nonagenarians yields excellent clinical improvement and pain relief.
• While functional improvement is moderate, TKA significantly enhances quality of life and ability to perform daily living activities.
• TKA is a viable option for carefully selected nonagenarian patients seeking relief from knee pain and improved quality of life.