Department of Orthopaedic Surgery, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Sakae-cho 35- 2, Itabashi-ku, Tokyo, 173-0015, Japan.
Eur J Orthop Surg Traumatol. 2024 Jan;34(1):155-160. doi: 10.1007/s00590-023-03634-7. Epub 2023 Jun 28.
The demand for simultaneous bilateral total knee arthroplasty (SiBTKA) in older adults is expected to increase with an aging population, thus necessitating evaluating its efficacy and safety. However, there is limited information regarding the clinical outcomes of SiBTKA in older adults, particularly in octogenarians. We aimed to assess the clinical outcomes and safety of SiBTKA in Japanese patients aged ≥ 80 years.
Of the 176 consecutive knees that underwent SiBTKA between July 2016 and January 2022 at our hospital, 172 were selected. They were divided into two groups according to the patient age as follows: the octogenarian group (≥ 80 years, 74 knees) and the younger control group (< 80 years, 98 knees). In addition, we assessed their preoperative clinical information, clinical outcomes using the Knee Society Score for knee (KSS-K) and function (KSS-F), and the incidence of early (≤ 90 days) and late (> 90 days) postoperative complications.
The mean follow-up period was 3.5 years. The KSS-K scores of both groups improved postoperatively than that preoperatively. Both preoperative and postoperative KSS-F scores were lower in the octogenarians; however, their improvement rates were similar to those of the younger controls. We observed no significant intergroup differences in early or late postoperative complications, including infection, systemic complications, periprosthetic fractures, aseptic loosening, and mortality.
SiBTKA for octogenarians had clinical outcomes and postoperative complication incidence similar to that for younger controls. Therefore, SiBTKA may be a safe and effective treatment option for octogenarians with painful bilateral knee deformities.
随着人口老龄化,老年人双侧全膝关节置换术(SiBTKA)的需求预计将会增加,因此需要评估其疗效和安全性。然而,关于 SiBTKA 在老年人中的临床结果,特别是在 80 岁以上的老年人中,信息有限。我们旨在评估 SiBTKA 在日本 80 岁及以上患者中的临床结果和安全性。
在我们医院,2016 年 7 月至 2022 年 1 月期间连续进行了 176 例 SiBTKA,其中 172 例被选中。根据患者年龄将其分为两组:80 岁以上组(≥80 岁,74 例膝关节)和年轻对照组(<80 岁,98 例膝关节)。此外,我们评估了他们的术前临床信息、膝关节 Knee Society 评分(KSS-K)和功能(KSS-F)的临床结果,以及早期(≤90 天)和晚期(>90 天)术后并发症的发生率。
平均随访时间为 3.5 年。两组患者术后 KSS-K 评分均高于术前。80 岁以上患者术前和术后 KSS-F 评分均较低;然而,他们的改善率与年轻对照组相似。我们没有观察到早期或晚期术后并发症(包括感染、全身并发症、假体周围骨折、无菌性松动和死亡率)在两组之间有显著差异。
SiBTKA 用于 80 岁以上患者的临床结果和术后并发症发生率与年轻对照组相似。因此,SiBTKA 可能是治疗伴有双侧膝关节疼痛畸形的 80 岁以上老年人的一种安全有效的治疗选择。