Pohl Nicholas B, Brush Parker L, Santana Adrian, Fras Sebastian I, Jenkins Eleanor, Saxena Arjun
From the Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
J Am Acad Orthop Surg Glob Res Rev. 2025 Aug 19;9(8). doi: 10.5435/JAAOSGlobal-D-25-00167. eCollection 2025 Aug 1.
Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients <60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages <60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.
Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (<60 years or ≥60 years) for analysis.
In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (<60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer <60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.
Patients younger than 60 years reported less satisfaction with performing normal activities and decreased normal knee function postoperatively. The <60 cohort reported requiring more readmissions for TKA concerns; however, no difference was observed in the rate of revision TKA between the cohorts. This information may be beneficial to clinicians and younger patients when discussing postoperative outcomes and functional expectations following TKA.
全膝关节置换术（TKA）是治疗年轻骨关节炎患者越来越常用的一种治疗选择。先前的研究发现，年龄小于60岁接受TKA手术的患者中，只有66%术后表示膝盖感觉正常。然而，之前的研究没有根据年龄比较不满意的潜在原因。本研究比较了年龄小于60岁和60岁及以上患者的满意度和残留症状率，并确定了不同年龄组之间不满意的具体原因。
对2014年至2016年因骨关节炎接受单侧TKA手术的患者，通过电子方式发送一份关于手术满意度的15个问题的调查问卷。在确认患者身份并完成调查后，通过人工查阅病历收集患者的人口统计学信息、病史、手术时间和住院时间。完成调查的患者按年龄（<60岁或≥60岁）分组进行分析。
总共纳入了1189例60岁及以上患者和388例小于60岁患者。两个队列中的大多数患者对膝关节整体功能表示满意（<60岁：68.6%；≥60岁：71.8%；P = 0.175）。报告膝关节功能正常的小于60岁患者较少（66.5%对75.2%；P < 0.001）。两个队列中最常见的残留症状是持续疼痛。
年龄小于60岁的患者对术后进行正常活动的满意度较低，膝关节正常功能下降。小于60岁的队列报告因TKA相关问题需要更多次再入院；然而，两个队列之间的TKA翻修率没有差异。这些信息在讨论TKA术后结果和功能预期时，可能对临床医生和年轻患者有益。
