Evidence map›Paper›PMID 26864215›Full record

SynthesisBMC geriatrics2016

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review.

Ethan F Kuperman, Marin Schweizer, Parijat Joy, Xiaomei Gu, Michele M Fang

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC geriatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 1 pooled it
8.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 1 synthesis or guideline pooled it, 90 citations in OpenAlex.

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  15. Risk Factors for Nonresilient Outcomes in Older Adults After Total Knee Replacement.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Ethan F KupermanDepartment of Internal Medicine, University of Iowa, Carver College of Medicine, SE 622 GH 200 Hawkins Drive, Iowa City, IA, 52242, USA. ethan-kuperman@uiowa.edu.
Marin SchweizerDepartment of Internal Medicine, University of Iowa, Carver College of Medicine, SE 622 GH 200 Hawkins Drive, Iowa City, IA, 52242, USA.
Parijat JoyDepartment of Internal Medicine, University of Iowa, Carver College of Medicine, SE 622 GH 200 Hawkins Drive, Iowa City, IA, 52242, USA. Parijat-joy@uiowa.edu.
Xiaomei GuHealth Sciences Clinical Education Librarian, Hardin Library of the Health Sciences, University of Iowa, Iowa City, IA, USA. Xiaomei-gu@uiowa.edu.
Michele M FangDepartment of Internal Medicine, University of Iowa, Carver College of Medicine, SE 622 GH 200 Hawkins Drive, Iowa City, IA, 52242, USA. Michele-fang@uiowa.edu.
University of Iowa · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTotal knee arthroplasty is an effective treatment when nonsurgical treatments fail, but it is associated with risk of complications which may be increased in advanced age. The purpose of this study was to quantify age-related differences in perioperative morbidity and mortality after total knee arthroplasty through systematic review of existing literature.

methodsPubMed, the Cochrane database of systematic reviews, Scopus, and clinicaltrials.gov, were queried for relevant studies that compared primary total knee arthroplasty outcomes of mortality, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE) and functional status, of geriatric patients (>75 years old) with a younger control group (<65 years old). Pertinent journals and reference lists were hand searched. Eligibility criteria included all articles except case reports, meta-analyses, and systematic reviews. Two authors independently extracted data from each paper. Article quality was assessed using the Newcastle-Ottawa Scale.

resultsTwenty-two studies were included. Geriatric patients had higher rates of mortality, MI, DVT, and length of stay in older compared to younger patients, however the absolute magnitude of these increases were small. The increase in mortality may have reflected decreased life expectancy in the geriatric populations as opposed to mortality specifically due perioperative risk. There were no differences in PE incidence and improvement in pain and functional status was equal in older and younger patients. Existing studies were limited by non-randomized patient selection, as well as variation in definitions and methodology.

conclusionsExisting data supports offering primary total knee arthroplasty to select geriatric patients, although the risk of complications may be increased. Much of the data was of poor quality. Future prospective studies are needed to better identify risks and benefits of total knee arthroplasty so that patients and surgeons can make informed decisions.

Indexed as

AgedAged, 80 and overAge FactorsArthroplasty, Replacement, KneeFemaleHumansMaleMiddle AgedMyocardial InfarctionPostoperative ComplicationsProspective StudiesPulmonary EmbolismTreatment OutcomeVenous Thrombosis

Identifiers

PMID26864215
PMCPMC4750247
OpenAlexW2255350683

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.