Knee arthroplasty in octogenarians: results at 10 years

The purpose of this study was to assess the long-term results of total knee arthroplasty (TKA) in octogenarians. Between 1976 and 1989, 1 surgeon at our institution performed 110 TKAs in 90 patients who were 80 years of age or older. No patients were lost to follow-up monitoring; all living patients underwent a minimum of 10 years (range, 10-19 years) followup care. There were 5 (3.4%) surgical complications, but at final follow-up examination, no implants had failed because of aseptic loosening. Of all patients, 96% experienced complete pain relief and 91% showed an excellent knee score (> or = 85) at final follow-up examination. Only 14% of patients had an excellent function score. The 88% death rate for our patient population, the fact that only 14% of patients had an excellent function score after surgery, and the lack of aseptic implant failure by the time of final follow-up examination after an average of 8 years with a conventional TKA raise the question of whether using expensive newer-design implants cost-effectiveness is in octogenarians.