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Total knee arthroplasty in the octogenarian
B Zicat1, C H Rorabeck, R B Bourne
1Department of Orthopaedic Surgery, University of Western Ontario, University Hospital, London, Canada.
The Journal of Arthroplasty
|August 1, 1993
Summary
Total knee arthroplasty is a reliable procedure for octogenarians (patients 80+). Elderly patients experienced similar outcomes to younger groups, demonstrating cost-effectiveness despite minor post-discharge cost increases.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Biomedical Engineering
Background:
- Osteoarthritis affects a growing elderly population, necessitating effective treatment options.
- Total knee arthroplasty (TKA) is a common surgical intervention for advanced osteoarthritis.
- Assessing TKA outcomes in octogenarians is crucial due to unique physiological considerations.
Purpose of the Study:
- To compare the clinical outcomes and cost-effectiveness of TKA in patients aged 80 and over versus a younger cohort (65-69 years).
- To evaluate the reliability and safety of TKA in an elderly population.
Main Methods:
- Prospective comparative study involving 50 octogenarian and 50 younger patients undergoing TKA.
- Clinical assessment using Hospital for Special Surgery (HSS) knee scores and radiographic evaluation.
- Minimum 2-year follow-up period for all participants.
Main Results:
- No significant differences in pain, function, strength, stability, or range of motion between octogenarians and the younger group over 2 years.
- Octogenarians presented with more prevalent and larger preoperative deformities, indicating more advanced disease.
- Slightly higher post-discharge costs were observed in the octogenarian group, while in-hospital costs and length of stay were comparable.
Conclusions:
- Total knee arthroplasty is a reliable and effective procedure for octogenarians with osteoarthritis.
- The procedure demonstrates good cost-effectiveness in the elderly population, similar to younger patients.
- Preoperative deformities are more common and severe in octogenarians, suggesting advanced osteoarthritis pathophysiology.