Octogenarians Are the New Sexagenarians: Cruciate-Retaining Total Knee Arthroplasty Is Not Inferior to Posterior-Stabilized Arthroplasty in Octogenarian Patients
Creators
- 1. IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy - Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, 20133 Milan, Italy
- 2. Division of Orthopedics and Traumatology, Government Medical College Trivandrum, Kerala University of Health Sciences, Thiruvananthapuram 695011, India
- 3. Gujarat Cancer Research Institute, Ahemadabad 380016, India
- 4. Institute for Maternal and Child Health IRCCS "Burlo Garofolo", 34137 Trieste, Italy
- 5. IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- 6. Department of Orthopaedic Surgery, Faculty of Medicine, University Hospital of Larissa, University of Thessalia, 41110 Larissa, Greece
Description
Abstract
Purpose: The primary goal of this study was to compare survivorship and functional results in individuals aged 80 and over who underwent total knee arthroplasty (TKA) with cruciate-retaining (CR) or posterior-stabilized (PS) implants.
Methods: We prospectively analyzed the clinical records of two consecutive cohorts for a total of 96 implants in patients aged 80 years or over. The first cohort consisted of 59 consecutive cemented PS cases, while the second cohort comprised 37 consecutive cemented CR cases. The decision to either perform a PS or CR arthroplasty was taken based on preoperative magnetic resonance imaging and intraoperative findings. The clinical evaluation entailed evaluating each patient's visual analogue scale for pain (VAS), range of motion (flexion and extension), Knee Society Score (KSS), and Oxford Knee Score (OKS). Each patient was clinically evaluated the day before surgery (T0) and at two consecutive follow-ups at least 1 (T1) and 2 (T2) years after surgery. Implant survival was calculated using the Kaplan-Meier method.
Results: Both groups showed statistically significant improvements at each follow-up compared with the preoperative values (p < 0.05). The CR group showed a higher flexion degree at T1 than the PS group (116.14 ± 5.57° versus 113.16 ± 7.66°; p = 0.048). No differences were found between the two groups regarding survival rate (chi-squared test p-value = 0.789). Three failures were noted in the CR group, while there were four in the PS group.
Conclusions: This prospective clinical study demonstrates that CR and PS TKA had similar clinical outcomes in octogenarians with regard to knee function, postoperative knee pain, and other complications. Prosthesis survivorship for CR and PS TKA were both satisfactory, and in selected octogenarian patients, CR TKA should always be considered because of the reduced surgical time.
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