Total knee replacement can be safely performed in octogenarian - a review of data from 2009 to 2014

Abstract

INTRODUCTION: Hong Kong octogenarian population is growing. In 2013, the life expectancies at birth for males and females were 81.1 and 86.7 years, respectively. There was an increase in the demand in octogenarians asking for total knee replacement (TKR) surgery. In 2014, 9.2% of primary TKRs were performed for patients >80 years in the Hospital Authority. This study aimed to report the clinical outcomes of TKR performed from 2009 to 2014. MATERIALS AND METHODS: Patients >80 years at the time of TKR were included. The clinical results and complications were reported. The clinical outcomes were compared with sex-matched patients in the same period. RESULTS: From 2009 to 2014, 266 TKRs were performed in 191 patients. Their mean age was 82.3 years (range, 80-91 years). The 30-day mortality was 0.4%. The incidence of pulmonary embolism (1.1%) and postoperative acute retention of urine (2.9%) were higher than the matched group. The incidence of deep infection was 1.1%, which was comparable with the matched group. The mean length of stay was significantly longer than the matched group. The trend showed a steady decrease in length of stay. Knee Society Knee Score and Knee Society Functional Assessment score were lower at 6 weeks. These became comparable from 3 months onwards. DISCUSSION AND CONCLUSION: Total knee replacement can be safely performed in the octogenarian patient group. The functional improvement is expected to be slower.