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Updated: Sep 9, 2025

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Published on: July 22, 2021
Knee arthroplasty can preserve cognitive function in patients with severe knee osteoarthritis
Juneyoung Heo1, Ji-Hoon Baek2, Chang Hyun Nam2
1Joint & Arthritis Research, Department of Neurosurgery, Himchan Hospital, Seoul, Republic of Korea.
Background:
This study examined how the clinical and radiological severity of knee osteoarthritis (OA) and various treatment methods affect cognitive function.
Method:
This prospective study included patients with knee pain or discomfort who visited a single institution between July 2017 and November 2022. Patients with Kellgren-Lawrence (K-L) grade 0 or treatable dementia were excluded from this study, and 88 patients were followed up for an average duration of 2.4 ± 1.3 years. Overall, 55 patients had K-L grade 4, of whom 45 who did not improve after >3 months of conservative treatment underwent knee arthroplasty.
Results:
Among patients with K-L grade 4, the decrease in the Mini-Mental State Examination score in patients who underwent surgery was significantly lower than that in other patients who received conservative treatment only.
Conclusion:
Knee arthroplasty can reduce the decline in cognitive function in patients with severe knee OA of K-L grade 4 who do not respond to conservative treatment. Even if pain is controlled with conservative treatment, the decline in cognitive function in patients with OA is faster than the age-related decline observed in the general population.
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