Patients aged 75 years and older report better pain relief than younger patients

All patients undergoing total knee arthroplasty (TKA) have improvement in outcomes; however, patients aged 75 years and older (late elders) achieve better pain relief and improved quality of life compared with younger patients (younger than 55 years), according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 7 to 11 in Las Vegas.

David Christopher Ayers, M.D., from the University of Massachusetts Medical School in Worcester, and colleagues conducted a prospective, multicenter study involving 11,602 unilateral primary TKA patients to examine whether outcomes vary according to patient age. Patients were stratified by age (younger than 55 years [younger adult], 55 to 64 years [older adult], 65 to 74 years [early elder], and 75 years and older [late elder]).

The researchers found that younger adults reported slightly worse pain, function, and quality of life but better function scores than late elder patients at one year after TKA. The differences in the mean one-year postoperative scores among the four age groups (range, 4.02 to 12.23) reached the minimal clinically important difference for pain and quality of life, but not for function.

Pain, function, and quality-of-life score improvements from baseline achieved by younger adults (36.8, 30.3, and 40.7 points, respectively) were comparable to those of other groups. Compared with younger adults, in late elders, age was predictive of knee injury and osteoarthritis outcome pain score.

"Orthopedic surgeons can recommend TKA as an appropriate and life-changing operation for people with advanced arthritis who do not respond to conservative care, even those over 75 years of age," Ayers said in a statement.

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