Impact of Age on Patient-Reported Outcome Measures in Total Knee Arthroplasty

Abstract

Patient expectations and demographics are vital factors in determining patient satisfaction and outcomes from total knee arthroplasty (TKA). This study was a retrospective chart review that analyzed data from TKA patients to determine the impact of age on patient-reported outcomes measures following TKA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford knee scores were collected as primary outcome measures from 356 consecutive patients who underwent TKA. Oxford knee scores were further divided into pain and function subscores. Patients were age categorized as <50, 50 to 59, 60 to 69, 70 to 79, and >79. Preoperative scores were compared among age categories including age category, gender, body mass index (BMI), and length of stay (LOS) in the model as fixed effects. Scores collected postoperatively (∼10, 30, 90, and 180 days postoperation) were analyzed as repeated measures including age category, day and their interaction, gender, BMI, LOS, and preoperative score in the model. Preoperative OXFORD scores significantly differed among age categories ( < 0.05) and were numerically higher for the older (≥60 years old) compared with younger patients (<60 years old). After adjusting for preoperative scores, postoperative WOMAC and overall, pain, and function OXFORD scores significantly differed among the age groups (< 0.05), with patients younger than 60 years reporting the worst scores in the postoperative time period. Older patients reported better preoperative overall, pain, and function scores and greater post-TKA outcomes than younger patients. A better understanding of factors that influence patient-reported outcomes can help providers to better manage patient expectations.

Two-year recovery courses of physical and mental impairments, activity limitations, and participation restrictions after total knee arthroplasty among working-age patients

“…Older age was the only factor that was positively associated with all courses. We analyzed age on a continuous scale, and these findings are in line with a previous study of Townsend et al, who found that TKA patients aged 50-59 years reported worse pain, function, and stiffness scores compared to those aged 60-69 years or older [35]. This might suggest that within the working-age population, specific age classes exist showing different patterns of recovery.…”

Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study

“…18 This is in line with the previously demonstrated sustained improvements in postoperative OKS between patients in each age group 60 to 69, 70 to 79, and >79. 31 The benefits of arthroplasty were universal, with a comparable improvement in clinical outcomes in all groups. After the initial phase with a higher complication rate, a similar natural history can be expected.…”

Is there an optimal age for total knee arthroplasty?: A systematic review

“…For SF-36 and LEAS, the cohorts 75 years and older had the lowest mean scores at various time points. In the mental component, those < 55 years had the lowest scores postoperatively Older better Townsend [ 29 ] J Knee Surg 2018 356 < 50, 50–59, 60–69, 70–79, > 79 Postoperative WOMAC and overall, pain, and function OKS significantly differed among the age groups ( P < 0.05), with patients younger than 60 years reporting the worst scores in the postoperative time period. Older patients reported better preoperative overall, pain, and function scores and greater post-TKA outcomes than younger patients Merle-Vincent [ 54 ] Joint Bone Spine 2011 264 ≤ 70, > 70, Age older than 70 years at surgery was associated with a higher satisfaction rate (odds ratio of age ≥ 70 years is 3.9 [1.1–14.3]; P = 0.038) Younger better Murphy [ 14 ] Bone Joint J 2018 2838 < 80, ≥ 80 SF-12 PCS, coefficient of ≥ 80-group is − 4.46 (− 6.18, − 2.73), P < 0.001 KJ Oh [ 26 ] Aging Clin Exp Res 2018 79 65–70, ≥ 80 The octogenarian patient group had significantly inferior outcomes for WOMAC and SF-36 score compared to the sexagenarian patient group ( P = 0.009 and P = 0.022, respectively) Naylor [ 28 ] Arthritis Care Res 2018 1289 Post operation 3 years: younger age ( P = 0.0018) was significantly associated with regular physical activity Razak [ 36 ] J Bone Joint Surg Am 2016 3062 Younger age KSS predicted a good outcome at 5 years (OKS: OR of age is 2.66 (2.61–2.71), SF-36 PCS: OR of age is 2.64 (2.59–2.67)) Singh [ 57 ] Osteoarthr Cartil 2010 7139 61–70, 71–80, > 80 Significantly predictors of overall moderate–severe activity limitation 2-years post-TKA was age 71–80 (OR: 2.1 [1.5, 2.8]) and age > 80 (OR: 4.1 [2.7, 6.1]) vs, ...…”