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Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty.
Arch Orthop Trauma Surg. 2018 Dec; 138(12):1755-1763.AO

Abstract

INTRODUCTION

Management of the young patient with end-stage osteoarthritis of the knee is difficult, with surgical options of osteotomy, partial or total knee arthroplasty (TKA). The primary aim of this study was to assess whether age of less than 55 years was an independent predictor of functional outcome and satisfaction after total knee arthroplasty (TKA). The secondary aims were to identify pre-operative differences in patient demographics, comorbidity and function between patients less than 55 years old compared to those 55 years old and over.

MATERIALS AND METHODS

A retrospective cohort consisting of 2589 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, comorbidity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year. Regression analysis was used to identify independent pre-operative predictors of change in the WOMAC and SF-12 scores, and patient satisfaction.

RESULTS

Patients less than 55 years old were significantly less likely to be satisfied with the overall outcome of their TKA (OR 0.4, p = 0.001). After adjusting for confounding variables age group was not an independent predictor of overall satisfaction with overall outcome (OR 0.71, p = 0.16). Independent predictors of an increased risk of dissatisfaction with the overall outcome at 1 year were depression (OR 0.58, p = 0.008) and worse pre-operative SF-12 MCS (p = 0.04).

CONCLUSION

Age of less than 55 years is not an independent predictor of functional outcome or rate of patient satisfaction after TKA. However, depression and poor mental health are significantly more prevalent in patients less than 55 years old and were independently associated with a lower satisfaction rate.

Authors+Show Affiliations

Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK. Lcwalker86@gmail.com.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30259126

Citation

Clement, N D., et al. "Patient Age of Less Than 55 Years Is Not an Independent Predictor of Functional Improvement or Satisfaction After Total Knee Arthroplasty." Archives of Orthopaedic and Trauma Surgery, vol. 138, no. 12, 2018, pp. 1755-1763.
Clement ND, Walker LC, Bardgett M, et al. Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty. Arch Orthop Trauma Surg. 2018;138(12):1755-1763.
Clement, N. D., Walker, L. C., Bardgett, M., Weir, D., Holland, J., Gerrand, C., & Deehan, D. J. (2018). Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty. Archives of Orthopaedic and Trauma Surgery, 138(12), 1755-1763. https://doi.org/10.1007/s00402-018-3041-7
Clement ND, et al. Patient Age of Less Than 55 Years Is Not an Independent Predictor of Functional Improvement or Satisfaction After Total Knee Arthroplasty. Arch Orthop Trauma Surg. 2018;138(12):1755-1763. PubMed PMID: 30259126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty. AU - Clement,N D, AU - Walker,L C, AU - Bardgett,M, AU - Weir,D, AU - Holland,J, AU - Gerrand,C, AU - Deehan,D J, Y1 - 2018/09/26/ PY - 2018/05/10/received PY - 2018/9/28/pubmed PY - 2019/1/15/medline PY - 2018/9/28/entrez KW - Age KW - Less than 55 years KW - Outcome KW - Satisfaction KW - Total knee arthroplasty KW - WOMAC SP - 1755 EP - 1763 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 138 IS - 12 N2 - INTRODUCTION: Management of the young patient with end-stage osteoarthritis of the knee is difficult, with surgical options of osteotomy, partial or total knee arthroplasty (TKA). The primary aim of this study was to assess whether age of less than 55 years was an independent predictor of functional outcome and satisfaction after total knee arthroplasty (TKA). The secondary aims were to identify pre-operative differences in patient demographics, comorbidity and function between patients less than 55 years old compared to those 55 years old and over. MATERIALS AND METHODS: A retrospective cohort consisting of 2589 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, comorbidity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year. Regression analysis was used to identify independent pre-operative predictors of change in the WOMAC and SF-12 scores, and patient satisfaction. RESULTS: Patients less than 55 years old were significantly less likely to be satisfied with the overall outcome of their TKA (OR 0.4, p = 0.001). After adjusting for confounding variables age group was not an independent predictor of overall satisfaction with overall outcome (OR 0.71, p = 0.16). Independent predictors of an increased risk of dissatisfaction with the overall outcome at 1 year were depression (OR 0.58, p = 0.008) and worse pre-operative SF-12 MCS (p = 0.04). CONCLUSION: Age of less than 55 years is not an independent predictor of functional outcome or rate of patient satisfaction after TKA. However, depression and poor mental health are significantly more prevalent in patients less than 55 years old and were independently associated with a lower satisfaction rate. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/30259126/Patient_age_of_less_than_55_years_is_not_an_independent_predictor_of_functional_improvement_or_satisfaction_after_total_knee_arthroplasty_ L2 - https://dx.doi.org/10.1007/s00402-018-3041-7 DB - PRIME DP - Unbound Medicine ER -