Abstract
Background
Since China's rapidly growing elderly population, we compared bilateral total knee arthroplasty (BTKA) outcome in patients between over 80 years and under 65 years for reliability, durability, and satisfaction.
Methods
Between March 2005 and January 2018, 114 patients (228 knees) received BTKA due to osteoarthritis met the inclusion criteria and were postoperatively followed-up ≥ three years. Patients included 83 BTKAs under 65 years (Group 1) and 31 BTKAs over 80 years (Group 2). The indexes included operative data, hemoglobin, Knee Society Score (KSS), Visual Analogue Scale (VAS), Range of Motion (ROM), “Forgotten Joint” Scale (FJS), crutches, patients’ satisfaction, and radiographic examinations.
Results
The clinical and functional KSS, VAS, and ROM in group 2 improved significantly less than that in group 1 from preoperative mean of 31, 26, 8 and 85° to latest follow-up of 87, 55, 0 and 93°, respectively (p < 0.05). The differences in blood loss and transfusion between two groups were correlated with stages, but not number of hospitalizations (p < 0.05). However, postoperative hemoglobin was correlated with number of hospitalizations, but not stages (p < 0.05). Thirteen patients still used crutches at last follow-up in group 2 (42%). The satisfaction rate in group 2 (90.3%) was lower than 99.4% in group 1 (p < 0.05). The proportion of FJS ≥ 50 was 96.4% in group 1 and 87.1% in group 2 (p < 0.05).
Conclusion
BTKA was reliable, durable, and satisfied in patients over 80 years in Chinese population, and more blood transfusion should be prepared in patients over 80 years.
Level of evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.