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Pain relief, functional improvement persist 20 years after knee arthroplasty
Meding JB. Clin Orthop Relat Res. 2011. doi 10.1007/s11999-011-2123-4
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Improvements in functional capacity and activity levels are persistent for 20 years or more following total knee arthroplasty, according to a study from researchers in Indiana.
The authors noted that aging — rather than implant-related issues — cause a gradual decline in the activity levels of these patients.
The team performed a retrospective review of 1,471 patients who underwent 1,757 primary cruciate-retaining total knee arthroplasties (TKAs) between 1975 and 1989. Of these patients, 128 (8.7%) who underwent a total of 171 TKAs were still alive. The authors prospectively determined Knee Society scores and retrospectively determined UCLA scores for each patient. Minimum follow-up in the study was 20 years.
Average age at the final follow-up was reported as 82.3 years. Sixty-six of the 128 patients died after the 20-year follow-up, accounting for 73 TKAs.
According to the study results, pain scores were found to have not worsened over time. Average knee scores were reported as 78, with function, stair and walking scores all being reported as having diminished over time. The authors found an average function score of 70 for the cohort, and noted that all but two of the patients could negotiate stairs. Ninety-five could walk at least 5 blocks, while 3 were reported as being housebound.
“TKA provides demonstrable pain relief and improved health-related quality of life,” the authors wrote. “Yet, a decline in physical function may occur over the long term despite the absence of implant-related problems.”