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02/26/2009
Octogenarians: Not Too Old for Joint Replacement
New study finds total knee replacement surgery can offer significant
benefits to patients in their 80s
Original Press Release
http://www6.aaos.org/news/pemr/releases/release.cfm?releasenum=744
Las Vegas, NV
Knee replacement surgery can improve the quality of life even for very elderly
patients, according to a study presented today at the 2009 Annual Meeting of the
American Academy of Orthopaedic Surgeons (AAOS). The study found that patients
in their 80s can benefit both physically and socially from knee replacement
surgery, also called total knee arthroplasty (TKA), once thought too risky for
the very elderly.
“As patients are living longer, there is an upward trend in the demand for
quality of life among the elderly population,” said Edsel Arandia, M.D., lead
author of the study and an orthopaedic surgeon at Philippine Orthopaedic Center
and a Fellow at Singapore General Hospital. “As patients age, debilitating
diseases like arthritis of the knee begin to develop. We conducted this study to
determine the viability of TKA in octogenarians and to learn whether their
quality of life improves after TKA.”
Dr. Arandia and his team reviewed data from 128 patients older than 80 years of
age who underwent knee replacement surgeries at Singapore General Hospital
between October 1998 and December 2006.
The results were measured using two quality-of-life scales, the SF-36 and the
Oxford Knee Score, which assign scores to elements of physical and emotional
health, such as:
•physical pain
•social functioning
•vitality
•physical functioning
When researchers compared the patients’ preoperative scores to their
postoperative scores up to 2 years following surgery, they found the patients’
quality of life scores had risen significantly during the postoperative period.
“The improvement in pain and function of elderly patients was remarkable as
early as 6 months and showed long-lasting improvement at the 2-year follow-up,”
Dr. Arandia noted. “Overall, total knee arthroplasty in elderly patients
resulted in significant gains in their quality of life, which was reflected in
both health- and social-related quality of life score dimensions.”
“In our institution, many surgeons are still skeptical to perform TKA in the
very elderly since few data or studies pertaining to the gains of TKA versus the
complications and risks that can occur with surgery in elderly patients exist,”
Dr. Arandia said. “This study shows that with the advent of new technology and
techniques in both orthopaedics and geriatric medicine, total knee arthroplasty
in the very elderly population is very safe and offers significant gains in
their quality of life.”
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