Study suggests appropriateness of TKA for young, willing patients with knee OA
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Patients aged 59 years and younger who seek consultation for total knee arthroplasty report worse knee osteoarthritis symptoms, higher procedure readiness and similar willingness compared with older patients, published results showed.
Gillian A. Hawker, MD, MSc, and colleagues performed a cross-sectional study of 2,037 patients with knee osteoarthritis (OA) who were referred for TKA in Alberta, Canada, from 2014 to 2016. According to the study, 67 patients (3.3%) were aged 50 years and younger, 462 patients (22.7%) were between 50 and 59 years of age and 1,508 patients (74%) were aged 60 years and older.
To assess the relationship between patient age and TKA appropriateness, researchers queried the prospective patients on perceived need (based on symptoms and prior treatment), TKA readiness, TKA willingness, health status, employment status and expectations.
Patients aged 59 years and younger had a higher mean WOMAC pain score (12.25) and a mean KOOS-physical function SF score (59.1) compared with patients aged 60 years and older (11.3 and 55.3, respectively).
Overall, TKA was offered to 52.2% of patients aged 50 years and younger, to 71% of patients between 50 and 59 years of age and to 75.4% of patients aged 60 years and older. After controlling for TKA appropriateness, Hawker and colleagues determined patient age was not associated with surgeons’ TKA recommendations.
“Younger people seeking TKA for knee OA had significant OA pain and disability despite recommended OA therapies, suggesting appropriateness for surgical consideration. However, they were significantly more likely to have morbid obesity, to smoke and to consider return to vigorous activities, like sport, as important TKA outcomes,” the researchers wrote in the study. “Incorporation of TKA-appropriateness criteria into TKA decision-making may facilitate consideration of TKA benefits and risks in a growing population of young, obese individuals with knee OA,” they added.
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