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

Abstract

Purpose The purpose of this systematic review was to elucidate the optimal age for patients undergoing total knee arthroplasty (TKA), to optimize the balance between the benefits and risks by analyzing patient-reported outcome measurements (PROM), revision rate, and mortality according to age. Materials and methods A rigorous and systematic approach was used and each of the selected studies was evaluated for methodological quality. Data were extracted according to the following: study design, patients enrolled, patient age at the time of surgery, follow-up period, PROM, revision rate, and mortality. Results Thirty-nine articles were included in the final analysis. The results were inconsistent in the PROM analysis, but there was consensus that PROM were good in patients in their 70s . In the revision rate analysis, there was consensus that the revision rate tends to increase in TKA in younger patients, but no significant difference was observed in patients > 70 years of age. In the mortality analysis, there was consensus that the mortality was not significantly different in patients < 80 years of age, but tended to increase with age. Conclusion This systematic review shows that the PROM were good when TKA was performed in patients between 70 and 80 years of age; the best PROM could be achieved around 70 years of age, and no significant difference in the revision or mortality rates was observed between 70 and 80 years of age; however, mortality tended to increase with age. Therefore, the early 70s could be recommended as an optimal age to undergo TKA.

Establishment of a Qualified Integrated Care System After Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Centers

“…[3] It also reported that the proportion of patients more than 70 years old increased markedly from 48.1% (2010) to 61% (2018) [3]. In this study, the mean age of all participants (72.0 ± 5.8) was in the early 70s, which was recommended as an optimal age for TKA that could achieve the maximal passive range of motion (PROM) without increasing the revision or mortality rates [13]. A total of 60.2% lived in urban areas, 65.9% lived in Jeju city of current administrative districts, and 47.6% lived in Jeju city of formal administrative districts.…”

Optimal Age Group Selection and Development of a Nomogram To Predict Complications in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty

“…Previous studies focused on the analysis of postoperative e cacy and perioperative complications in patients of different ages after TKA [19,20]. Regardless of age, the satisfaction rate of knee surgery is more than 85%, and advanced age does not affect the e cacy of TKA [19].Other scholars have found that 70 years old is the best age for TKA [20]. There was no difference in the incidence of complications among patients younger than 75 years of age who received unilateral TKA or staged bilateral TKA [14].Different from previous studies, this study divided all patients undergoing SBTKA into age groups to study the incidence of complications in each group.…”

“…TKA has become an effective measure for the treatment of end-stage knee diseases, which can effectively improve joint function and relieve pain [1-3, 4-7, 19, 23, 26]. Previous studies focused on the analysis of postoperative e cacy and perioperative complications in patients of different ages after TKA [19,20]. Regardless of age, the satisfaction rate of knee surgery is more than 85%, and advanced age does not affect the e cacy of TKA [19].Other scholars have found that 70 years old is the best age for TKA [20].…”

Establishment of Qualified Integrated Care System after Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Center

“…11 These occupations were categorized as three groups depending on their degree of physical work: non-manual workers (managers, professionals and related workers, and clerks), service or sales workers, and manual workers (skilled agricultural, forestry, shery, craft, and related trades workers, equipment, machine operating and assembling workers, and elementary workers). 12…”