Total Knee Arthroplasty in the Elderly. Is There an Age Limit?

Hernández-Vaquero, Daniel; Fernández-Carreira, José Manuel; Pérez-Hernández, D.; Fernández-Lombardía, J.; García-Sandoval, M. A.

doi:10.1016/j.arth.2005.05.030

Cited by 24 publications

(9 citation statements)

References 17 publications

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“…Due to the variation in the measurement scales it was not feasible to statistically combine these results. When comparing the geriatric to younger patients undergoing TKA, six studies reported no statistically significant differences in post-operative functional status [ 16 , 17 , 21 , 23 , 24 , 27 , 29 , 36 ]. Three studies [ 28 , 35 , 37 ] reported statistically worse scores in older patients.…”

Section: Resultsmentioning

confidence: 99%

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

et al. 2016

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BackgroundTotal knee arthroplasty is an effective treatment when nonsurgical treatments fail, but it is associated with risk of complications which may be increased in advanced age. The purpose of this study was to quantify age-related differences in perioperative morbidity and mortality after total knee arthroplasty through systematic review of existing literature.MethodsPubMed, the Cochrane database of systematic reviews, Scopus, and clinicaltrials.gov, were queried for relevant studies that compared primary total knee arthroplasty outcomes of mortality, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE) and functional status, of geriatric patients (>75 years old) with a younger control group (<65 years old). Pertinent journals and reference lists were hand searched. Eligibility criteria included all articles except case reports, meta-analyses, and systematic reviews. Two authors independently extracted data from each paper. Article quality was assessed using the Newcastle-Ottawa Scale.ResultsTwenty-two studies were included. Geriatric patients had higher rates of mortality, MI, DVT, and length of stay in older compared to younger patients, however the absolute magnitude of these increases were small. The increase in mortality may have reflected decreased life expectancy in the geriatric populations as opposed to mortality specifically due perioperative risk. There were no differences in PE incidence and improvement in pain and functional status was equal in older and younger patients. Existing studies were limited by non-randomized patient selection, as well as variation in definitions and methodology.ConclusionsExisting data supports offering primary total knee arthroplasty to select geriatric patients, although the risk of complications may be increased. Much of the data was of poor quality. Future prospective studies are needed to better identify risks and benefits of total knee arthroplasty so that patients and surgeons can make informed decisions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0215-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

et al. 2016

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“…7 The incidences of TKA in patients aged >80 years have been increasing in various knee registries. [8][9][10][11][12] the two groups. After adjustment for confounding factors, Charlson Comorbidity Index >5, history of major cerebrovascular accident, and history of peptic ulcer disease were predictive of complications after fast-track TKA (P=0.039, P=0.016, and P=0.007, respectively); octogenarian status was not predictive of complications.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of fast-track total knee arthroplasty for patients aged >80 years

Leung¹,

Ch²,

Chang³

et al. 2022

Hong Kong Med J

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Kong, there is an increasing incidence of total knee arthroplasties (TKA) conducted in patients aged >80 years. Methods:This retrospective case-control study enrolled all patients who were aged >80 years and underwent fast-track primary TKA between 2011 and 2015. Their outcomes were compared with the outcomes of a matched control group of younger patients who underwent fast-track TKA in the same period.Results: In total, 220 patients were included in this study with a follow-up period of at least 2 years (mean=3.2 years; range, 2-5 years); 112 (51%) were octogenarians and 108 (49%) were nonoctogenarians. Greater improvement in Knee Society Score was found in the octogenarian group at 1 year after surgery (46 ± 19 vs 39 ± 16, P=0.018). The incidence of complications was higher in the octogenarian group (15.2% vs 4.6%, P=0.009). There were no significant differences in the incidence of major complications, the rate of intensive care unit admission, or the 1-year mortality rate between

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“…Elderly patients undergoing TKA frequently have multiple comorbid illnesses and are at an increased risk for perioperative morbidity and mortality [4,12]. Previous investigators [4] have identified independent risk factors for periprosthetic joint infection and mortality after primary TKA.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Early Revision After Primary TKA in Medicare Patients

Bozic

Lau

Ong

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Patient, surgeon, health system, and device factors are all known to influence outcomes in total knee arthroplasty (TKA). However, patient-related factors associated with an increased risk of early failure are not well understood, particularly in elderly patients. Questions/purposes The purpose of this study was to identify specific comorbid conditions associated with increased risk of early revision in Medicare patients undergoing TKA. Methods A total of 117,903 Medicare patients who underwent primary TKA between 1998 and 2010 were identified from the Medicare 5% national sample administrative database and used to determine the relative risk of revision within 12 months after primary TKA as a function of baseline medical comorbidities. Cox regression was used to evaluate the impact of 29 comorbid conditions on risk of early failure controlling for age, sex, race, census region, socioeconomic status, and all other baseline comorbidities. Results The most significant independent risk factors for revision TKA within 12 months were chronic pulmonary

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Total Knee Arthroplasty in the Elderly. Is There an Age Limit?

Cited by 24 publications

References 17 publications

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

Clinical outcomes of fast-track total knee arthroplasty for patients aged >80 years

Risk Factors for Early Revision After Primary TKA in Medicare Patients

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