Trigueros-Larrea Jose Maria, Gonzalez-Bedia Maria Antonia, Lomo-Garrote Jose Maria, Martin-de la Cal Oscar, Martin-Ferrero Miguel Angel
Orthopaedic Surgery and Traumatology Department, Hospital Clinico Universitario Valladolid, 47005 Valladolid, Spain.
Centro ORIGEN, Diagnostico y Traumatologia, Department of Traumatology, 47006 Valladolid, Spain.
Geriatrics (Basel). 2021 Jun 30;6(3):67. doi: 10.3390/geriatrics6030067.
Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society Function Score (KSFS), extension and flexion balance, and radiologic alignment using a paired Student t-test. A chi-squared test was used to correlate mortality with Charlson comorbidities index score and with ASA scale. Kaplan-Meier analysis was performed to calculate patient survival. In this period 36 patients ≥80 years underwent TKA, with a mean age of 81.6 years. Of these, 24 patients (66.7%) were classified as ASA II and 12 (33.3%) as ASA III. Sixteen patients (44.4%) were Charlson 0, 14 (38.9%) Charlson 1, two (5.6%) Charlson 2, and four (11.1%) Charlson 3. KSS, KSFS, flexion and extension range, and radiologic alignment were statistically significant ( < 0.001) when comparing preoperatory and post-operatory data. No correlation ( > 0.05) was found between mortality and ASA or Charlson score. Seven patients (19.4%) suffered a medical complication and two patients experienced surgical complications. Four patient died (11.1%) during follow-up. The mean patient survival was 67.4 months. Patients ≥80 years achieve clinical improvement after TKA. Comorbidities, not age, are the burden for surgery in older patients.
随着社会老龄化，未来几年对八旬老人全膝关节置换术（TKA）的需求将会增加。我们对2015年至2019年间接受TKA手术的八旬老人进行了一项回顾性观察研究，使用配对学生t检验比较术前和术后的膝关节协会评分（KSS）、膝关节协会功能评分（KSFS）、屈伸平衡和放射学对线情况。采用卡方检验将死亡率与Charlson合并症指数评分以及美国麻醉医师协会（ASA）分级相关联。进行Kaplan-Meier分析以计算患者生存率。在此期间，36例80岁及以上患者接受了TKA手术，平均年龄为81.6岁。其中，24例患者（66.7%）被分类为ASA II级，12例（33.3%）为ASA III级。16例患者（44.4%）Charlson评分为0，14例（38.9%）Charlson评分为1，2例（5.6%）Charlson评分为2，4例（11.1%）Charlson评分为3。比较术前和术后数据时，KSS、KSFS、屈伸范围和放射学对线差异具有统计学意义（<0.001）。未发现死亡率与ASA或Charlson评分之间存在相关性（>0.05）。7例患者（19.4%）发生内科并发症，2例患者出现外科并发症。4例患者（11.1%）在随访期间死亡。患者平均生存时间为67.4个月。80岁及以上患者TKA术后临床症状得到改善。合并症而非年龄是老年患者手术的负担。
