Total knee arthroplassty results in patient over 80 years old in comparison with younger age groups

Introduction: Technological advancement and improved life expectancy tend to expand the musculoskeletal disorder pool which comes along with aging. One of the most frequent diseases of such character is knee arthrosis. The most relevant treatment modality has been Total Knee Replacement (TKR) in this entity for 20-30 years. TKR is preferred for relatively younger ages of the senior population with appropriate robustness yet with decreased activity level, although the age sometimes creates a standalone challenge. We aimed to determine whether there happened to be a cutoff age limit regarding TKR currently. Material & method: 207 case files of TKR with min. 5 years of follow-up operated between 2010-2016 in Başkent University Hospital (Ankara) were collected. We sorted them into four age groups as <60, 60-70, 70-80, 80< y.o. Individuals reoperated in the given time interval were excluded to sustain homogeneity for the population. All the patients were requested to visit the hospital for further investigation and physical examination. We recorded dates of death for patients who passed away. We further statistically evaluated mortality rate, Knee Society Score, Visual Analogue Scale, Lysholm Score, range of motion, activity level, etc. Results: 70 < y.o females dominated the total research population. Mortality incidence for the initial 5 years was 6,8% (n=14) which as well reflected the ultimate mortality incidence of the research population. All the cases who passed belonged to females of the 79 < yo age group. Preoperative, postoperative, and total hospitalization rates and clinical outcomes demonstrated no significant difference among age groups. Postoperative improvement in the Clinical Frailty Scale was statistically significant (p<0.05) in the 79 < age group compared to others. Conclusion: Considering the robustness and the anticipated life quality improvement after TKR in patients older than 80 years old, age does not appear to present a standalone indication factor. Therefore, TKR effectuates predictable, reasonable, reliable, cost-effective, and efficient surgical outcomes for every age, including 80 years and older. Keywords: arthroplasty, total knee replacement, frailty, older age, mortality