Is Total Knee Arthroplasty a Viable Treatment Option in Octogenarians with Advanced Osteoarthritis?

This study directly compared clinical assessment scores and short-term systemic complications after total knee arthroplasty (TKA) between a group of patients aged 80 or older (141 patients) and another group of patients aged between 65 and 70 years (616 patients) with advanced osteoarthritis.

We retrospectively investigated 757 osteoarthritic patients who underwent primary TKA from January 2007 to January 2011 with a follow-up of 1 year. The surgery was performed using an extramedullary alignment guide instrument without invasion of the intramedullary canal to decrease embolic load and blood loss.

At 1 year after surgery, the mean Knee Society knee score was improved in both groups (from 63.6 to 83.2 in octogenarians and from 68.3 to 89.0 in the younger group) and the level of satisfaction was excellent in both groups (8 in octogenarians and 8.3 in the younger group), even though there was no notable change in function score in the octogenarians (from 61.0 to 61.9 in the octogenarians and from 62.3 to 73.6 in the younger group). The total incidence of systemic complications (3.4% vs. 1.2%, p=0.400) and surgical complications (2.1% vs. 0.5%, p=0.229) showed no significant difference between groups.

TKA yielded favorable clinical outcomes with a comparatively low postoperative complication rate in octogenarians despite the negligible functional improvement.