Skip to main content

Table 2 Results for patient-reported outcome measures (PROM)

From: Is there an optimal age for total knee arthroplasty?: A systematic review

Author Journal Year Number Age (years) Result
No difference
 Sveikata [33] Geriatr Orthop Surg Rehabil 2017 314 < 75, ≥ 75 Post operation 1 year: no difference in pain (P = 0.592), stiffness (P = 0.729), or function (P = 0.082) according to WOMAC and SF-12 physical (P = 0.082) and mental (P = 0.559) health score
 Escobar [31] J Eval Clin Pract 2017 492   No difference between minimal clinically important difference (MCID)/patient acceptable symptom state (PASS) (P = 0.5)
 Lizaur-Utrilla [35] Knee Surg Sport Traumatol Arthrosc 2016 ≤ 55: 61
60–70: 61
≤ 55, 60–70 Post operation 5 years, there were no significant differences between groups in KSS knee or function, WOMAC pain or function, or SF-12 physical or mental. However, there were better results in younger patients for KSS function (P = 0.018), WOMAC function (P = 0.028), SF-12-physical (P = 0.001) and SF-12-mental (P = 0.035), although clinically relevant
 Maempel [40] Acta Orthop 2015 3144 < 75, 75–80, > 80 Post operation 5 years: all groups showed similar substantial improvements in AKS, which were maintained (all P < 0.001)
 Kuo [44] J Orthop Surg Res 2014 1024 < 80, ≥80 Both groups (≥ 80, < 80) had improved in the KSS (≥ 80: 86, < 80: 88), KSFS (≥ 80: 87, < 80: 89), WOMAC (≥ 80: 15.0, < 80: 14.6) scores
 Hamilton [47] BMJ Open 2013 4709   Median age of satisfied group is 70.3 and unsatisfied group is 70.0 (P = 0.829)
 Kennedy [48] Clin Orthop Rel Res 2013 ≥80: 438
< 80: 2754
< 80, ≥80 There was no difference in pain scores at 3, 5, and 10 years between the ≥ 80 years group and
< 80 years group. The KSS was comparable between groups at year 5, but the KSFS was lower in the octogenarians
 William [50] Bone Joint J 2013 2456 < 55
55–64, 65–74, 75–84, ≥ 85
Postoperative scores were comparable across age groups, but a linear trend for greater postoperative improvement in OKS and EQ-5D was seen with decreasing age (P < 0.033)
 Clement [53] Bone Joint J 2011 677 < 80, ≥ 80 Post operation 1 year: no significant difference was observed between the groups in the mean improvement in OKS (95% CI − 0.65 to 2.94, P = 0.16)
Difference
 Pitta [25] J Arthroplast 2019 3693   For the KOOS pain, KOOS activity, and LEAS outcomes, the divergence point occurred at age 68 years. For the KOOS symptom outcomes, the divergence point occurred at age 70 years.
 Elmallah [34] J Knee Surg 2016 278 < 55, 55–74, > 74 For KSS objective, patiemts 75 years and older had the highest mean score at final follow up (97 points). In KSS function, the < 55-years group had highest scores at 2-year (90 vs. 87 vs. 75 points) and 5-year follow up (96 vs. 88 vs. 72 points). For SF-36 and LEAS, the cohorts 75 years and older had the lowest mean scores at various time points. In the mental component, those < 55 years had the lowest scores postoperatively
Older better
 Townsend [29] J Knee Surg 2018 356 < 50, 50–59,
60–69, 70–79,
> 79
Postoperative WOMAC and overall, pain, and function OKS significantly differed among the age groups (P  < 0.05), with patients younger than 60 years reporting the worst scores in the postoperative time period. Older patients reported better preoperative overall, pain, and function scores and greater post-TKA outcomes than younger patients
 Merle-Vincent [54] Joint Bone Spine 2011 264 ≤ 70,
> 70,
Age older than 70 years at surgery was associated with a higher satisfaction rate (odds ratio of age ≥ 70 years is 3.9 [1.1–14.3]; P = 0.038)
Younger better
 Murphy [14] Bone Joint J 2018 2838 < 80,
≥ 80
SF-12 PCS, coefficient of ≥ 80-group is − 4.46 (− 6.18, − 2.73), P < 0.001
 KJ Oh [26] Aging Clin Exp Res 2018 79 65–70,
≥ 80
The octogenarian patient group had significantly inferior outcomes for WOMAC and SF-36 score compared to the sexagenarian patient group (P = 0.009 and P = 0.022, respectively)
 Naylor [28] Arthritis Care Res 2018 1289   Post operation 3 years: younger age (P = 0.0018) was significantly associated with regular physical activity
 Razak [36] J Bone Joint Surg Am 2016 3062   Younger age KSS predicted a good outcome at 5 years (OKS: OR of age is 2.66 (2.61–2.71), SF-36 PCS: OR of age is 2.64 (2.59–2.67))
 Singh [57] Osteoarthr Cartil 2010 7139 61–70,
71–80,
> 80
Significantly predictors of overall moderate–severe activity limitation 2-years post-TKA was age 71–80 (OR: 2.1 [1.5, 2.8]) and age > 80 (OR: 4.1 [2.7, 6.1]) vs, age ≤ 60 years, and 5 years post-TKA was age 71–80 (OR: 2.4 [1.7, 3.5]) and age > 80 (OR: 4.7 [2.8, 7.9]) vs. age ≤ 60 years
Extreme age
Extreme old age
  Skinner [37] Ann R Coll Surg Eng 2016 67 70–79,
90–99
For preoperative OKS no significant difference between nonagenarians and control group
Extreme young age
  Lange [27] J Arthroplast 2018 1058 18–55,
65–75
Distribution of satisfaction responses was shifted toward greater satisfaction in older patients (P < 0.001). Younger patients reported greater knee-related dysfunction and higher activity levels preoperatively and postoperatively (P = 0.0002)
  Haynes [32] Knee 2017 ≤ 55: 82
65–75: 85
≤55,
65–75
The younger patient cohort reported substantially lower preoperative clinical outcome scores. WOMAC pain (12.1 points, P < 0.01), and WOMAC physical function. (6.9 points, P < 0.01) improvement was noted; however, WOMAC pain score remained lower among the younger patient cohort
  Clement [19] Arch Arthop Trauma Surg 2018 2589 < 55, 55 ≤ The younger age group was twice as likely to be dissatisfied with their overall outcome and pain relief, with only 83% and 85% being satisfied compared to 92% and 91% in the older age group, respectively
  1. KSS Knee Society Score, WOMAC Western Ontario and McMaster Osteoarthritis Index, KSFS Knee Society Function Score, OKS Oxford Knee Score, OR odds ratio, SF Short Form, PCS Physical Component Score, AKS American Knee Society, LEAS Lower Extremity Activity Scale, ADL activities of daily living, TKA total knee arthroplasty