Age-Related Functional Decline Following Total Knee Arthroplasty: Risk Adjustment is Mandatory
| Autor: | Lily Lee, Amir Khoshbin, Michael Pitta, Geoffrey H. Westrich, Stephen Lyman, Pauline Woo, Anum Lalani |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Aging medicine.medical_specialty Time Factors Activities of daily living Total knee arthroplasty Pain Prom Osteoarthritis 03 medical and health sciences 0302 clinical medicine Activities of Daily Living medicine Humans Orthopedics and Sports Medicine Patient Reported Outcome Measures Registries Range of Motion Articular Functional decline Arthroplasty Replacement Knee Generalized estimating equation Aged Pain Measurement Retrospective Studies 030222 orthopedics business.industry Age Factors Recovery of Function Middle Aged Osteoarthritis Knee Risk adjustment medicine.disease Comorbidity Treatment Outcome Physical therapy Female Risk Adjustment business |
| Zdroj: | The Journal of Arthroplasty. 34:228-234 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2018.09.046 |
| Popis: | Background Patient-reported outcome measures (PROMs) are being used increasingly to determine the success of total knee arthroplasty (TKA). Our goal is to investigate whether advanced age is associated with lower PROM scores. Methods We used our hospital’s TKA registry to examine the relationship between age and PROMs in all patients 50-90 years of age who underwent unilateral or simultaneous bilateral primary TKA between 2007 and 2011 with a primary diagnosis of osteoarthritis. All 5 domains of the Knee Injury and Arthritis Outcomes Score (KOOS) and the Lower Extremity Activity Scale (LEAS) at baseline, 2 years, and 5 years were collected. The association between age and PROM score was assessed by piecewise linear regression using generalized estimating equations, adjusting for demographics, comorbidity, and baseline score. Results Significant nonlinear relationships among age, KOOS subdomains, and LEAS were found. The placement of the age spline knot was at 70 years for KOOS Symptom and 68 years for KOOS Pain, KOOS Activities of Daily Living (ADL), and LEAS. The KOOS Symptom domain showed a significant worsening between 2-year and 5-year follow-up (P Conclusion We found an age-related decline in KOOS Pain, KOOS Symptom, KOOS ADL, and LEAS scores. The best fitting spline knots were at 68 (KOOS Pain, KOOS ADL, and LEAS) and 70 years (KOOS Symptoms), respectively. This demonstrates that there is a critical age at which functional decline begins regardless of the quality of the TKA surgery. Our findings will help surgeons accurately guide patient expectations after TKA based on age. Level of Evidence Level II, prognostic study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect