ArticleArchives of orthopaedic and trauma surgery2025
Short-term outcomes of elective revision total knee arthroplasty in elderly patients: a comparative analysis of octogenarians and septuagenarians.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeRevision total knee arthroplasty (rTKA) is more complex and carries higher risks than primary TKA, especially in patients aged ≥ 80 years. This study examines whether elective rTKA yields similar clinical outcomes and complication rates in octogenarians compared to septuagenarians (70-79 years).
methodsFrom 2010 to 2022, we identified 57 patients aged ≥ 80 years who underwent their first rTKA with at least a two-year follow-up at a single institution. These patients were matched 1:2 based on rTKA indication with 114 patients aged 70-79 years. Data collected included demographics, revision indications, perioperative outcomes, complications, reinterventions, and Knee Society Scores (KSS). These variables were compared between septuagenarians and octogenarians with student-t tests or Mann-Whitney u tests.
resultsAseptic loosening was the most common revision indication in both groups (32.8% of all cases). Septuagenarians received more constrained condylar knee (CCK) implants (51% vs. 23%), while octogenarians received more hinged implants (54% vs. 38%). At 2 years, septuagenarians had higher KSS Function scores (72.7 ± 14.9 vs. 56.8 ± 11.4, p < 0.001). Octogenarians experienced higher complication rates (26.3% vs. 9.6%, p = 0.006) and reinterventions (15.8% vs. 6.2%, p = 0.05).
conclusionOctogenarians undergoing rTKA exhibited lower functional outcomes and gains, along with higher rates of postoperative complications and reinterventions compared to septuagenarians. Further evaluation using patient frailty indices may improve understanding and help balance the risks and benefits of revision surgery in this population.
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