Comorbidities rather than age affect medium-term outcome in octogenarian patients after total knee arthroplasty
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Comorbidities rather than age affect medium‑term outcome in octogenarian patients after total knee arthroplasty Valerio Andreozzi1 · Fabio Conteduca1 · Raffaele Iorio1 · Enrico Di Stasio2,3 · Daniele Mazza1 · Piergiorgio Drogo1 · Alessandro Annibaldi1 · Andrea Ferretti1 Received: 25 July 2019 / Accepted: 4 November 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose As the population ages, it is important to determine whether total knee arthroplasties (TKA)s are safe and beneficial in the octogenarian population. The aims of the present study were: (1) to assess the effect of comorbidities and age on the incidence of postoperative complications following TKA and (2) to evaluate the mid-term outcome of octogenarian patients. Methods A retrospective matched-paired analysis by gender, BMI and duration of follow-up was conducted on 206 patients older than 80 years and younger than 75 years between 2009 and 2016, undergoing primary TKA. The mean follow-up was 5 years. Outcome measures including Oxford Knee Score (OKS), Knee Society Score (KSS), Knee Society Function Score (KSFS), postoperative complications, length of stay (LOS) and survivorship were analysed. The association between complications and comorbidities was assessed using multivariable logistic regression after adjusting for age, Deyo-Charlson Comorbidity Index (D-CCI) and the American Society of Anesthesiologist’s (ASA) physical status classification. Results In the multivariable models, D-CCI class is an independent predictor for postoperative cardiac complications, delirium and transfusion rate (OR ranging from 1.2 to 69.5 in respect to D-CCI reference class 0). Being ≥ 80 years old was associated with an increased risk of transfusion (OR 3.4; 95% CI 1.7–6.8) and 1.7-day increase in LOS (p
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