Do octogenarian patients undergoing total knee replacement return to physical activity?

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Rehabilitation science

Background:

• Total knee replacement (TKR) is known to enhance functional capacity and physical activity.
• The specific impact of patient age on TKR outcomes, particularly physical activity levels, requires further elucidation.

Purpose of the Study:

• To evaluate the pre- and postoperative physical activity in patients undergoing TKR.
• To compare functional outcomes between different age groups following TKR, specifically focusing on the influence of age.

Main Methods:

• A retrospective cohort study analyzed 450 patients who underwent TKR between 2016 and 2019.
• Patients were divided into two age groups: 65-79 years (Group A) and 80+ years (Group B).
• Outcomes were assessed using the Knee Society Score (KSS) and Tegner functional scale, with comparisons made between age groups.

Main Results:

• Patients younger than 80 (Group A) showed significantly greater improvement in Tegner scores (1.19) compared to those 80 and older (Group B) (0.61).
• While older patients (Group B) demonstrated a higher increase in the KSS clinical subscale (KSSc) (53 points vs. 43 points), younger patients (Group A) had a more substantial improvement in the KSS functional subscale (KSSf) (33.91 points vs. 15.57 points).
• Age over 80 was identified as an independent risk factor for reduced Tegner improvement and KSSf improvement.

Conclusions:

• Total knee replacement leads to significant improvements in physical and functional activity across all patient populations.
• However, patients younger than 80 years generally experience more pronounced functional gains and activity improvements post-TKR.
• Age is a critical determinant of the extent of functional recovery after total knee replacement.