Risk-Benefit on Quality of Life After Total Knee Arthroplasty in Octogenarians

Clinical outcomes of total knee arthroplasty (TKA) in very older patients have been widely studied, but the available evidence on quality of life (QOL) is limited. The objective was to evaluate the impact of TKA on the QOL in octogenarian patients and assess whether the risk-benefit justified surgery.

Prospective study comparing 143 octogenarian and 149 septuagenarian patients. QOL was assessed with the Short Form-12 (SF-12) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires and functional outcomes with the Knee Society score (KSS). Comorbidity, complications, pain, and satisfaction were also assessed.

Mean postoperative follow-up was 3.2 years (range, 2-5 years). Comorbidities, medical complications, transfusion rate, and length stay were not different between groups (P < .05). Comorbidities and complications had no influence on the outcomes. There were no significant differences in preoperative knee KSS, WOMAC, or SF-12 mental scores, but octogenarians had significantly lower functional KSS (P = .003) and SF-12 physical scores (P = .005). At the last follow-up, there were no significant differences in KSS, WOMAC, and SF-12 physical scores (P < .05), but octogenarians had higher SF-12 mental (P = .030) and satisfaction (P = .031) scores.

TKA provided pain relief, satisfaction, and improvement in QOL for octogenarian patients to the level of the septuagenarian patients. TKA was a suitable option for octogenarian patients with appropriate surgical indications and manageable risk.