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Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?

Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society F...

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Autores principales: Trigueros-Larrea, Jose Maria, Gonzalez-Bedia, Maria Antonia, Lomo-Garrote, Jose Maria, Martin-de la Cal, Oscar, Martin-Ferrero, Miguel Angel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293102/
https://www.ncbi.nlm.nih.gov/pubmed/34209013
http://dx.doi.org/10.3390/geriatrics6030067
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author Trigueros-Larrea, Jose Maria
Gonzalez-Bedia, Maria Antonia
Lomo-Garrote, Jose Maria
Martin-de la Cal, Oscar
Martin-Ferrero, Miguel Angel
author_facet Trigueros-Larrea, Jose Maria
Gonzalez-Bedia, Maria Antonia
Lomo-Garrote, Jose Maria
Martin-de la Cal, Oscar
Martin-Ferrero, Miguel Angel
author_sort Trigueros-Larrea, Jose Maria
collection PubMed
description Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society Function Score (KSFS), extension and flexion balance, and radiologic alignment using a paired Student t-test. A chi-squared test was used to correlate mortality with Charlson comorbidities index score and with ASA scale. Kaplan–Meier analysis was performed to calculate patient survival. In this period 36 patients ≥80 years underwent TKA, with a mean age of 81.6 years. Of these, 24 patients (66.7%) were classified as ASA II and 12 (33.3%) as ASA III. Sixteen patients (44.4%) were Charlson 0, 14 (38.9%) Charlson 1, two (5.6%) Charlson 2, and four (11.1%) Charlson 3. KSS, KSFS, flexion and extension range, and radiologic alignment were statistically significant (p < 0.001) when comparing preoperatory and post-operatory data. No correlation (p > 0.05) was found between mortality and ASA or Charlson score. Seven patients (19.4%) suffered a medical complication and two patients experienced surgical complications. Four patient died (11.1%) during follow-up. The mean patient survival was 67.4 months. Patients ≥80 years achieve clinical improvement after TKA. Comorbidities, not age, are the burden for surgery in older patients.
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spelling pubmed-82931022021-07-22 Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive? Trigueros-Larrea, Jose Maria Gonzalez-Bedia, Maria Antonia Lomo-Garrote, Jose Maria Martin-de la Cal, Oscar Martin-Ferrero, Miguel Angel Geriatrics (Basel) Article Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society Function Score (KSFS), extension and flexion balance, and radiologic alignment using a paired Student t-test. A chi-squared test was used to correlate mortality with Charlson comorbidities index score and with ASA scale. Kaplan–Meier analysis was performed to calculate patient survival. In this period 36 patients ≥80 years underwent TKA, with a mean age of 81.6 years. Of these, 24 patients (66.7%) were classified as ASA II and 12 (33.3%) as ASA III. Sixteen patients (44.4%) were Charlson 0, 14 (38.9%) Charlson 1, two (5.6%) Charlson 2, and four (11.1%) Charlson 3. KSS, KSFS, flexion and extension range, and radiologic alignment were statistically significant (p < 0.001) when comparing preoperatory and post-operatory data. No correlation (p > 0.05) was found between mortality and ASA or Charlson score. Seven patients (19.4%) suffered a medical complication and two patients experienced surgical complications. Four patient died (11.1%) during follow-up. The mean patient survival was 67.4 months. Patients ≥80 years achieve clinical improvement after TKA. Comorbidities, not age, are the burden for surgery in older patients. MDPI 2021-06-30 /pmc/articles/PMC8293102/ /pubmed/34209013 http://dx.doi.org/10.3390/geriatrics6030067 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Trigueros-Larrea, Jose Maria
Gonzalez-Bedia, Maria Antonia
Lomo-Garrote, Jose Maria
Martin-de la Cal, Oscar
Martin-Ferrero, Miguel Angel
Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title_full Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title_fullStr Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title_full_unstemmed Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title_short Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
title_sort total knee arthroplasty in octogenarians: should we still be so restrictive?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293102/
https://www.ncbi.nlm.nih.gov/pubmed/34209013
http://dx.doi.org/10.3390/geriatrics6030067
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