Total knee arthroplasty in carefully selected patients aged 80 years or older

Journal of Orthopaedic Surgery and Research

Jun-Wen Wang¹  Wun-Schen Chen¹  Chi-Hsiang Hsu¹  Feng-Chih Kuo¹ 

[1] Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, No.123, Ta Pei Road, Niao Sung Dist, Kaohsiung City 833, Taiwan

关键词: Postoperative complications;    Mortality;    Total knee arthroplasty;    Octogenarian;   

Others  :  1152494
DOI  :  10.1186/s13018-014-0061-z

 received in 2014-02-28, accepted in 2014-07-01,  发布年份 2014

【 摘 要 】

Background

The patients aged ≥80 years have been considered to have a higher risk of mortality, postoperative complications, and longer hospital stay following total knee arthroplasty (TKA) than younger patients. The purposes of this retrospective study were to review the results of TKA in patients aged ≥80 years after a preoperative consultation.

Methods

Seventy-five patients aged ≥80 years underwent TKA from January 2006 and June 2010. A control group of younger patients (65–74 years) was matched in a 1:1 ratio with the ≥80 years group for sex, diagnosis of the disease, body mass index, the American Society of Anesthesiologists' type of anesthesia, and comorbidities. Cardiologists and neurologists carefully evaluated the risk of patients for both groups before surgery. The groups were compared with regard to Knee Society Scores, Knee Society Function Score, Western Ontario and McMaster Universities Osteoarthritis Index scores, length of stay, postoperative complications, and 90-day mortality rate.

Results

The mean follow-up was 2.3 years (range 1–5 years). We found no difference in the functional outcomes and length of stay between the two groups. The ≥80 years group had a higher rate of blood transfusion (29.3% versus 10.7%, p = 0.006) after Bonferroni correction. There were no cardiovascular or cerebrovascular complications in the ≥80 years group. There were no mortalities within 90 days in either group.

Conclusions

Despite similar functional results and pain relief of the TKA compared with the young patient group, the ≥80 years group had a higher complication rate of blood transfusion. With a preoperative consultation by cardiologists and neurologists, patients aged ≥80 years have a low cardiovascular or cerebrovascular complications and 90-day mortality after TKA.

【 授权许可】

   
2014 Kuo et al.; licensee BioMed Central Ltd.

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