Total knee arthroplasty in the octogenarian

Fifty consecutive Miller-Galante (Zimmer, Warsaw, IN) and Kinematic II (Howmedica, Rutherford, NJ) total knee arthroplasties for osteoarthritis in patients 80 years of age and over were compared to 50 arthroplasties in patients aged 65-69 years, with a minimum 2-year follow-up period. Each patient was assessed clinically using the Hospital for Special Surgery knee rating scores and radiographically by an independent observer. Average age of the study group participants was 83 years and of the comparison group, 68 years. Apart from age, the two groups were similar with respect to sex, bilaterality, prosthetic type, and preoperative Hospital for Special Surgery scores. No significant differences were noted for pain, functional level, strength, stability, or range of motion throughout the 2-year follow-up period. More octogenarian patients were found to have a preoperative deformity, and these deformities were larger, on average, than in the retiree group, suggesting a more advanced disease pathophysiology. A larger number of elderly patients required continued use of walking aids. An analysis of the cost-effectiveness data, collected for both groups, showed that although the in-hospital costs and length of stay were the same ($17,160 Can), the cost per patient after discharge was slightly greater ($2,000 Can) in the octogenarian. This prospective clinical study of total knee arthroplasties for osteoarthritis has shown that it is a reliable and cost-effective procedure for the octogenarian.