Health outcome after total knee replacement in the very elderly

Abstract

Between 1992 and 1994 we performed a prospective study of the effect of total knee replacement (TKR) on the health status of 119 patients over the age of 80 years who had had a primary unilateral TKR. The Nottingham Health Profile was used to assess this before and at three and 12 months after operation. We found a significant improvement in the scores for pain, emotional reaction, sleep and physical mobility at three months. After 12 months, the scores for pain and sleep were well maintained. The other factors had deteriorated slightly but remained better than before operation. Our findings show that TKR leads to a significant improvement in the general health status of the very elderly.

Quality of life after knee revision arthroplasty

“…This may be due to the more extensive nature of revision surgery, or perhaps to poorer muscle function in revision patients. However, in stark contrast to primary knee replacement studies (Birdsall et al 1999, Wright et al 2004, there were no significant improvements in any other domains of the NHP.…”

“…This reduction in NHP pain is maintained well at 1 year; by 5 years, in the worst case scenario it is no worse than pre-revision. This change in NHP pain over time, for revision TKR, parallels that shown for primary TKR, but with change of lower magnitude (Birdsall et al 1999, Ethgen et al 2004). We found no other significant changes in NHP profile following revision TKR.…”

“…ies have shown an improvement in quality of life (pain, sleep, physical mobility) after primary knee arthroplasty (Cloutier 1983, Rissanen et al 1995, Hawker et al 1998, Birdsall et al 1999) and good survivorship after revision total knee replacement (Khaw et al 2001). Hozack et al (1997) showed that even with similar preoperative health dimensions using the SF-36 questionnaire, physical function and overall perception of health were significantly higher for patients undergoing a primary total hip replacement than for a revision study group.…”

“…Hawker et al 1998, Birdsall et al 1999, Ewald et al 1999, March et al 1999, Khaw et al 2001. The survival rate for revision knee arthroplasty has consistently been found to be less than for primary replacement (Ritter et al 1991, Saleh et al 2003.…”

Functional gain following knee replacement in patients aged 75 and older: a prospective follow-up study

“…However, the functional benefit after TKA is considered to be the less favorable than after total hip arthoplasty [9]. While physical function is obviously more limited in the aged after TKA when compared with younger patients [9], it is increased compared to baseline [13], and the smaller gains are possibly related to existing comorbidities [14].…”