Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.
J Arthroplasty. 2021 Nov;36(11):3656-3661. doi: 10.1016/j.arth.2021.06.014. Epub 2021 Jun 24.
As a procedure with lower surgical morbidity, unicompartmental knee arthroplasty (UKA) may present a practical solution for elderly patients with unicompartmental arthritis. However, few studies have analyzed the results of UKA in the extreme elderly. This study compared the functional and perioperative outcomes between octogenarians and age-appropriate controls undergoing UKA.
Prospectively collected data of 44 patients aged ≥80 years who underwent unilateral UKA were analyzed. Each octogenarian was matched 1:3 with 132 patients aged 65-74 years using propensity scores adjusting for gender, body mass index, Charlson comorbidity index, and preoperative scores. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and Short Form-12 were collected preoperatively and 2 years postoperatively. Complications, reoperations, readmissions, and unplanned visits were recorded up to 1 year postoperatively.
The mean age was 70.0 ± 2.7 years in the control group and 83.0 ± 3.0 years in the octogenarian group (P < .001). The percentage of outpatient procedures was comparable (control 50.0%; octogenarian 45.5%; P = .601). With the exception of poorer Short Form-12 physical scores in octogenarians at 2 years (39.4 ± 14.1 vs 44.9 ± 9.2, P = .028), there was no difference in final postoperative scores or improvement in scores between the groups. The rate of complications, reoperations, readmissions, and emergency room visits was also similar. The five-year survivorship was 97% in the control group and 93% in the octogenarian group (P = .148).
Octogenarians undergoing UKA can experience clinical outcomes that are similar to those of their younger counterparts. The clinical trajectory outlined may help clinicians provide valuable prognostic information to elderly patients and guide preoperative counseling.
作为一种手术并发症发生率较低的术式，单髁膝关节置换术（UKA）可能为单间室关节炎的老年患者提供了一种实用的解决方案。然而，很少有研究分析 UKA 在极老年患者中的结果。本研究比较了接受 UKA 的 80 岁以上高龄患者和年龄匹配的对照组患者的功能和围手术期结果。
前瞻性收集了 44 例年龄≥80 岁的单侧 UKA 患者的数据进行分析。每位 80 岁以上的患者与 132 例年龄为 65-74 岁的患者进行了 1:3 的倾向性评分匹配，匹配因素包括性别、体重指数、Charlson 合并症指数和术前评分。在术前和术后 2 年收集膝关节损伤和骨关节炎关节置换评分（Knee Injury and Osteoarthritis Outcome Score for Joint Replacement，KOOS）和简短形式健康调查量表 12 项（Short Form-12，SF-12）。记录术后 1 年内的并发症、翻修手术、再入院和非计划性就诊。
对照组的平均年龄为 70.0±2.7 岁，80 岁以上组的平均年龄为 83.0±3.0 岁（P<0.001）。门诊手术的比例相似（对照组为 50.0%；80 岁以上组为 45.5%；P=0.601）。除了 80 岁以上组患者在术后 2 年的简短形式健康调查量表 12 项的物理评分较差（39.4±14.1 与 44.9±9.2，P=0.028）外，两组的最终术后评分或评分改善无差异。并发症、翻修手术、再入院和急诊就诊的发生率也相似。对照组的 5 年生存率为 97%，80 岁以上组为 93%（P=0.148）。
接受 UKA 的 80 岁以上患者可获得与年轻患者相似的临床结果。本研究概述的临床轨迹可能有助于临床医生为老年患者提供有价值的预后信息，并指导术前咨询。
