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Mid-term lifetime survivals of octogenarians following primary and revision total knee arthroplasties were satisfactory: a retrospective single center study in contemporary period

Knee Surgery & Related Research 2020년 32권 1호 p.50 ~ 50
송상준, 김광일, 배대경, 박철희,
소속 상세정보
송상준 ( Song Sang-Jun ) - Kyung Hee University College of Medicine Department of Orthopaedic Surgery
김광일 ( Kim Kang-Il ) - Kyung Hee University College of Medicine Department of Orthopaedic Surgery
배대경 ( Bae Dae-Kyung ) - Kyung Hee University College of Medicine Department of Orthopaedic Surgery
박철희 ( Park Cheol-Hee ) - Kyung Hee University College of Medicine Department of Orthopaedic Surgery

Abstract


Background: As life expectancy increases, the number of octogenarians requiring primary and revision total knee arthroplasty (TKA) is increasing. Recently, primary TKA has become a common treatment option in octogenarians. However, surgeons may still be hesitant about performing revision TKA on octogenarians because of concern about risk and cost benefit. The purpose of this study was to investigate clinical outcomes, postoperative complications, and mid-term lifetime survival in octogenarians after primary and revision TKA.

Materials and methods: We retrospectively reviewed 231 primary TKAs and 41 revision TKAs performed on octogenarians between 2000 and 2016. The mean age of patients undergoing primary TKA was 81.9 years and that of patients undergoing revision TKA was 82.3 years (p?=?0.310). The age-adjusted Charlson comorbidity index was higher in revision TKA (4.4 vs. 4.8, p?=?0.003). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM) were evaluated. The incidence of postoperative complications (TKA-related, specific or systemic) and lifetime survival rate (endpoint death determined by telephone or mail communication with patient or family) were investigated.

Results: The WOMAC and ROM improved significantly after primary and revision TKA, although postoperative results were worse in the revision group (33.1 vs. 47.2; 128.9° vs. 113.6°; p
Conclusions: Both primary and revision TKA are viable options for octogenarians, based on the satisfactory clinical outcomes, TKA-related complication rates, and mid-term lifetime survival. Delirium needs to be managed appropriately as the most common systemic complication in both primary and revision TKA in octogenarians.

키워드

Octogenarian; Knee; Arthroplasty; Revision; Survival; Complication

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