Cher Eric Wei Liang, Tay Kae Sian, Zhang Karen, Tan Seang Beng, Howe Tet Sen, Koh Joyce Suang Bee
Department of Orthopaedic Surgery, Singapore General Hospital, Bukit Merah, Singapore.
Geriatr Orthop Surg Rehabil. 2018 May 16;9:2151459318769508. doi: 10.1177/2151459318769508. eCollection 2018.
According to the World Health Organization data repository, the average life expectancy at birth for Singapore in 2015 has risen to 83.4 years, and many octogenarians (OG) remain active socioeconomically. The aim of this study is to compare the improvement and the impact of comorbidities on functional recovery after total knee arthroplasty (TKA) between OG and their younger counterparts.
This is a retrospective study of prospectively collected data from a single institution arthroplasty register. Between January 2006 and December 2011, 209 OG with primary knee osteoarthritis underwent TKA. Each OG (mean age 82 ± 2.1) was then carefully matched to a younger control group (YG, mean age 66 ± 4.5). Their postoperative outcomes measured include Oxford Knee Score (OKS), SF36-Physical Function (SF-PF), and knee society rating score comprising of Knee Score (KS) and Function Score (FS). Their respective degrees of improvement were compared and adjusted for their baseline comorbidities, measured using the Deyo-Charlson Comorbidity Index (D-CCI).
There were more comorbidities among the OG ( < .05). Both groups saw the largest improvement ( < .05) during the first 6 months. There was no statistical significance between their improvement for OKS, KS, and FS between baseline and 6 months and OKS, FS, and SF-PF between 6 and 24 months. Adjusted for D-CCI using linear regression, the above results remained largely unchanged.
In our study, both groups showed significant improvement across all functional outcomes, especially during the first 6 months. The improvement observed in OG at 6 and 24 months was comparable to that of YG, despite an overall higher baseline D-CCI.
Total knee arthroplasty is a viable treatment option for the OG, offering good functional outcomes and results at 6 and 24 months when compared to their younger counterparts.
根据世界卫生组织数据储存库的数据，2015年新加坡的出生时平均预期寿命已升至83.4岁，许多八旬老人在社会经济方面仍很活跃。本研究的目的是比较八旬老人与其年轻同龄人在全膝关节置换术（TKA）后功能恢复方面合并症的改善情况及其影响。
这是一项对前瞻性收集的来自单一机构关节置换登记处数据的回顾性研究。2006年1月至2011年12月期间，209名患有原发性膝关节骨关节炎的八旬老人接受了全膝关节置换术。然后，将每位八旬老人（平均年龄82±2.1岁）与一个年轻对照组（年轻组，平均年龄66±4.5岁）仔细匹配。测量的术后结果包括牛津膝关节评分（OKS）、SF36身体功能评分（SF-PF）以及由膝关节评分（KS）和功能评分（FS）组成的膝关节协会评分。比较他们各自的改善程度，并根据使用迪尤-查尔森合并症指数（D-CCI）测量的基线合并症进行调整。
八旬老人的合并症更多（P<0.05）。两组在头6个月内改善最大（P<0.05）。他们在基线至6个月期间OKS、KS和FS的改善情况与6至24个月期间OKS、FS和SF-PF的改善情况之间无统计学意义。使用线性回归根据D-CCI进行调整后，上述结果基本保持不变。
在我们的研究中，两组在所有功能结果方面均显示出显著改善，尤其是在头6个月。尽管八旬老人的基线D-CCI总体较高，但在6个月和24个月时观察到的改善情况与年轻组相当。
全膝关节置换术对于八旬老人是一种可行的治疗选择，与年轻同龄人相比，在6个月和24个月时能提供良好的功能结果。
