Improvements in functional outcome and quality of life are not sustainable for patients ≥ 68 years old 10 years after total knee arthroplasty

Abstract

Purpose The aims of this study are to evaluate whether improvements in functional outcome and quality of life are sustainable 10 years after total knee arthroplasty (TKA), and the age cutoff for clinical deterioration in outcomes Methods Prospectively collected registry data of 120 consecutive patients who underwent TKA at a tertiary hospital in 2006 was analysed. All patients were assessed at 6 months, 2 years and 10 years using the Knee Society Function Score, Knee Society Knee Score, Oxford Knee Score, Short-Form 36 Physical/Mental Component Scores and postoperative satisfaction. One-way ANOVA was used to compare continuous variables, while Chi-squared test to compare categorical variables. Multivariate logistic regression and receiver operating curve analysis was performed to evaluate the predictive factors associated with deterioration of scores postoperatively. Results Significant improvements were noted in all functional outcome and quality of life scores at 6 months after TKA. Between 6 months and 2 years, the KSFS and OKS continued to improve but the KSKS, PCS and MCS plateaued. Between 2 and 10 years, there was a deterioration in the KSFS and OKS, whilst KSKS, PCS and MCS were maintained. Increasing age was noted to be a significant risk factor for deterioration of KSFS at 10 years with age ≥ 68 as the cutoff value. 91.7% of patients with KSFS Minimally Clinically Important Difference(MCID) (≥ 7 points) continued to be satisfied after 10 years compared to 100.0% who did not experience KSFS MCID deterioration (p = 0.02). Conclusion Patients ≥ 68 years experience deterioration in functional outcomes and quality of life from 2 to 10 years after TKA. Level of evidence Retrospective study, Level III.

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

“…Knee Peking Union Medical College HS [ 370 ] 2. Chinese People’s Liberation Army [ 539 ] Hong Kong Hong Kong Institutional Queen Mary HS [ 282 , 367 , 471 , 554 , 617 , 622 ] Japan Takatsuki (Hip) Takatsuki General HS [ 359 ] Korea Korea Korean Hip (KHR) [ 489 ] Republic of China Taiwan Chang Gung Memorial HS [ 83 , 422 , 475 , 557 ] Singapore Singapore Singapore General HS [ 108 , 124 , 168 , 192 , 227 , 229 , 245 , 253 , 273 , 277 , 284 , 434 , 436 , 440 , 443 , 466 , 467 , 513 , 538 , 546 , 579 , 591 , 595 , 602 , 608 , 612 , 616 , 621 , ...…”

The dynamic impact of Joint Awareness on Quality of Life after Total Knee Arthroplasty: a longitudinal study

“…Our results are consistent with the study of Cao, which found that FJS was weakly positively correlated to MCS [ 10 ]. Although it may not be surprising, positive emotions are beneficial to the recovery of joints, and mental health is affected by many factors, such as self-efficacy and cognition [ 33 , 34 ]. As a result, future research should explore the dynamic relationship between forgotten joint and psychological QoL so as to increase patient awareness of the full spectrum of diseases and treatment methods for patients.…”

SMART choice (knee) tool: a patient‐focused predictive model to predict improvement in health‐related quality of life after total knee arthroplasty

“…Patient‐specific predictors based on clinical relevance and a literature review were considered for the model 41–46 . Potential predictors that required clinician expertise, such as radiographic findings and blood test results, were excluded.…”

“…Patient-specific predictors based on clinical relevance and a literature review were considered for the model. [41][42][43][44][45][46] Potential predictors that required clinician expertise, such as radiographic findings and blood test results, were excluded. Predictors used for the model development included age (continuous), gender (binary), ethnicity (categorical), body mass index (BMI) (continuous), socioeconomic indicator for areas (categorical), remoteness (categorical), indication for TKA (categorical), comorbidities (categorical), Charlson comorbidity index (categorical), VR12 responses (continuous discrete for combined scores and categorical per question), Short-Form 6 Domains (categorical), and Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) (continuous discrete for combined scores and categorical per question).…”