Worse functional status among old people when admitted for arthroplasty--an evaluation with a new assessment system

The aim of this study was to investigate whether there is a difference in functional status between younger and elderly people referred to an orthopaedic clinic for total joint replacement. A total of 709 patients with osteoarthritis of the hip or knee (aged 27-91 years) and 42 healthy controls (aged 42-83 years) were examined with a new Functional Assessment System (FAS) for lower extremity dysfunction. Age effects were explored by one-way analysis of variance. Older people showed higher dysfunction scores in almost all variables, with the exception of pain, where there was an inverse relationship, i.e, old people had lower disability scores. This age-related increase in disability scores was not observed in the control group. Old people seem to be referred for joint replacement on different grounds from those of younger people, despite the fact that age was not included in the criteria for arthroplasty. The results may indicate a hidden, age-related criterion in the selection of patients for arthroplasty. Different interpretations are discussed.