The effects of age on patient-reported outcome measures in total knee replacements.

Journal article

We present a comparison of patient-reported outcomes (PROMs) in relation to patient age, in patients who had received a total (TKR) or unicompartmental knee replacement (UKR). The outcome was evaluated using the Oxford knee score (OKS), EuroQol (EQ-5D) and satisfaction scores. Patients aged 65 to 84 years demonstrated better pre-operative function scores than those aged < 65 years (OKS, p = 0.03; EQ-5D, p = 0.048) and those aged ≥ 85 years (OKS, p = 0.03). Post-operative scores were comparable across age groups, but a linear trend for greater post-operative improvement in OKS and EQ-5D was seen with decreasing age (p < 0.033). The overall mean satisfaction score at six months was 84.9, but those aged < 55 years exhibited a lower mean level of satisfaction (78.3) compared with all other age groups (all p < 0.031). The cumulative overall two-year revision rate was 1.3%. This study demonstrates that good early outcomes, as measured by the OKS and EQ-5D, can be anticipated following knee replacement regardless of the patient's age, although younger patients gain greater improvement. However, the lower satisfaction in those aged < 55 years is a concern, and suggests that outcome is not fully encapsulated by the OKS and EQ-5D evaluation, and raises the question whether the OKS alone is an appropriate measure of pain and function in younger, more active individuals.

Authors: Williams, D; Price, A; Beard, D; Hadfield, S; Arden, N

• Publication status: Published
• Journal: bone and joint journal
• Volume: 95-B
• Issue: 1
• Pages: 38-44
• Publication date: 2013-01-01
• DOI: 10.1302/0301-620x.95b1.28061
• EISSN: 2049-4408
• ISSN: 2049-4394
• Language: English
• Keywords: Reoperation; Patient Satisfaction; Humans; Arthroplasty, Replacement, Knee; Aged, 80 and over; Linear Models; Adult; Questionnaires; Follow-Up Studies; Male; Health Status Indicators; Osteoarthritis, Knee; Middle Aged; Treatment Outcome; Female; Logistic Models; Aged; Age Factors; Pain Measurement