By EurekAlert
Thursday, February 17, 2011
Most patients who undergo total knee replacement (TKR) are age
60 to 80. More than 90 percent of these individuals experience a
dramatic reduction in knee pain and a significant improvement in
the ability to perform common activities. However questions have
been raised about the decline in physical function over the long
term despite the absence of implant-related problems. New research
revealed today at the 2011 Annual Meeting of the American Academy
of Orthopaedic Surgeons (AAOS) evaluates patient functionality 20
years after knee replacement.
"It is a common concern for older adults to wonder how they will
function several years after the knee replacement and if revision
will be necessary," explained John B. Meding MD, study author and
Attending Orthopaedic Surgeon, The Center for Hip and Knee Surgery,
Mooresville, IN.
Although aging may cause a gradual decline in physical activity,
a remarkable functional capacity and activity level continues 20
years of more after TKR.
Between 1975 and 1989, 1,757 primary cruciate (ligament behind
the knee)-retaining TKRs were preformed at the Center for Hip and
Knee Surgery in Mooresville, IN. The study examined 128 patients
who were living at the 20 year follow-up. The average age at
operation in the group of 171 TKRs was 63.8 years. Eighty-two
percent of these patients had osteoarthritis and 73 percent were
female. The average follow-up was 21.1 years and the average age at
follow-up was 82.3 years.
The study found:
- Ninety-five patients could walk at least five blocks.
- Nearly half, 48 percent, of patients reported unlimited
walking.
- All but two patients could negotiate up and down stairs without
a banister.
- Only three patients were considered housebound.
- There were no implant failures after 20 years.
"These findings definitely add to the conversation with patients
considering surgery. If a patient actually lives that long, a
well-functioning TKR may help allow them to maintain a remarkable
functional capacity and activity level not just for five or 10
years but for 20 years and beyond," continued Dr. Meding. "This
research refutes any perception that the importance of a
well-functioning TKR diminishes over time because of an overall
declining functional status. Elderly people are using their
surgically replaced knees for fairly active lifestyles many years
after surgery."
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