Gregory Hodgson , Samantha Jones , Jad Wehbe , Irrum Afzal , Nick D Clement , Deiary F Kader
{"title":"Patients aged 80 years and older have an equal improvement in joint-specific outcome health related quality of life and level of satisfaction when compared to those aged 65–75 years old undergoing knee arthroplasty","authors":"Gregory Hodgson , Samantha Jones , Jad Wehbe , Irrum Afzal , Nick D Clement , Deiary F Kader","doi":"10.1016/j.knee.2025.02.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>To assess functional outcomes, health-related quality-of-life (HRQoL), and satisfaction at 1-year following knee arthroplasty (KA) in patients aged ≥80 compared to those aged 65–75-years when adjusting for confounding factors.</div></div><div><h3>Methods</h3><div>A single-centre retrospective cohort study was performed using data from 2010 to 2020. Demographic data, length of stay (LOS), preoperative and 1-year postoperative EuroQol (EQ-5D and EQ-VAS), Oxford Knee Score (OKS) and Outcome Satisfaction (OS) were recorded. Patients aged ≥80 were compared to a control group aged 65–75-years. Regression analyses were performed to assess the independent association of age group after adjusting for confounding factors.</div></div><div><h3>Results</h3><div>Compared to the 65–75-year group (<em>n</em> = 7525) the ≥80-year group (<em>n</em> = 2966) had greater comorbidity (<em>p</em> < 0.001), worse preoperative OKS (<em>p</em> < 0.001) and EQ-VAS (<em>p</em> = 0.012). Postoperatively both groups had clinically and statistically significant (<em>p</em> < 0.001) improvements in OKS, EQ-5D and EQ-VAS. There was no difference in improvement in OKS (mean difference (<em>p</em> = 0.081) or OS (<em>p</em> = 0.203) between the groups. However, the ≥80-year group had less of an improvement in EQ-5D (<em>p</em> = 0.047) and EQ-VAS (<em>p</em> = 0.007), but these were not clinically meaningful. However, when adjusting for confounding variables there were no differences in improvement in OKS (<em>p</em> = 0.372), EQ-5D (<em>p</em> = 0.703), and EQ-VAS (<em>p</em> = 0.283), or OS (<em>p</em> = 0.829) between the groups. The ≥80-year group was independently associated with a longer LOS (95% CI 0.3–0.8, <em>p</em> < 0.001) when adjusting for confounding factors.</div></div><div><h3>Conclusions</h3><div>Patients ≥80-years had clinically significant improvements in joint-specific outcome and HRQoL and OS equal to those aged 65–75-years following KA. The ≥80 group had a longer mean LOS of half a day.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"54 ","pages":"Pages 209-216"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016025000316","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Patients aged 80 years and older have an equal improvement in joint-specific outcome health related quality of life and level of satisfaction when compared to those aged 65–75 years old undergoing knee arthroplasty
Aims
To assess functional outcomes, health-related quality-of-life (HRQoL), and satisfaction at 1-year following knee arthroplasty (KA) in patients aged ≥80 compared to those aged 65–75-years when adjusting for confounding factors.
Methods
A single-centre retrospective cohort study was performed using data from 2010 to 2020. Demographic data, length of stay (LOS), preoperative and 1-year postoperative EuroQol (EQ-5D and EQ-VAS), Oxford Knee Score (OKS) and Outcome Satisfaction (OS) were recorded. Patients aged ≥80 were compared to a control group aged 65–75-years. Regression analyses were performed to assess the independent association of age group after adjusting for confounding factors.
Results
Compared to the 65–75-year group (n = 7525) the ≥80-year group (n = 2966) had greater comorbidity (p < 0.001), worse preoperative OKS (p < 0.001) and EQ-VAS (p = 0.012). Postoperatively both groups had clinically and statistically significant (p < 0.001) improvements in OKS, EQ-5D and EQ-VAS. There was no difference in improvement in OKS (mean difference (p = 0.081) or OS (p = 0.203) between the groups. However, the ≥80-year group had less of an improvement in EQ-5D (p = 0.047) and EQ-VAS (p = 0.007), but these were not clinically meaningful. However, when adjusting for confounding variables there were no differences in improvement in OKS (p = 0.372), EQ-5D (p = 0.703), and EQ-VAS (p = 0.283), or OS (p = 0.829) between the groups. The ≥80-year group was independently associated with a longer LOS (95% CI 0.3–0.8, p < 0.001) when adjusting for confounding factors.
Conclusions
Patients ≥80-years had clinically significant improvements in joint-specific outcome and HRQoL and OS equal to those aged 65–75-years following KA. The ≥80 group had a longer mean LOS of half a day.
期刊介绍:
The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee.
The topics covered include, but are not limited to:
• Anatomy, physiology, morphology and biochemistry;
• Biomechanical studies;
• Advances in the development of prosthetic, orthotic and augmentation devices;
• Imaging and diagnostic techniques;
• Pathology;
• Trauma;
• Surgery;
• Rehabilitation.