Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study
Introduction With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. Th...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2020-07, Vol.140 (7), p.949-956 |
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| description | Introduction
With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. The aim of this study was to determine if there were differences in functional and HRQoL measures between older patients (≥ 75 years) and younger controls ( |
| doi_str_mv | 10.1007/s00402-020-03440-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_journals_2413232073</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2392464734</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-daf53c7b3fa0136cecf39e7b3fdd80a54ff07949866eebae1b9886da646e1a593</originalsourceid><addsrcrecordid>eNqNkc-K1TAUxosoznX0BVxIwI0g1ZM_TZuVDBf_wYALdV3S9PTejm1Tk5Sh-DI-i0_muXYcwYW4SfKF33dycr4se8zhBQcoX0YABSIHATlIpSBXd7IdV1Ll0nB9N9uBkTqvoOBn2YMYrwC4qAzcz86kkKDB8F327ePRL0PLZpt6nFJk9oAtK4sf31e0ITIfmB9aDGyZaD14NmLb24Fk7_w425BGstHFlwmRkTwGPw82pvUVu2AzCZxin1YWnQ-Yjza5Iz0Q09KuD7N7nR0iPrrZz7PPb15_2r_LLz-8fb-_uMydLIuUt7YrpCsb2VngUjt0nTR40m1bgS1U10FplKm0Rmws8sZUlW6tVhq5LYw8z55tdamdrwvGVI99dDgMdkK_xFpII5RWpVSEPv0LvfJLmKi7WihOYxNQSqLERrngYwzY1XPoRxvWmkN9iqbeoqkpmvpXNPWp9JOb0ktDQ7y1_M6CgGoDrrHxXXSUh8NbDAAKURbAFZ1A7PtEiflp75cpkfX5_1uJlhsdiZgOGP588h_9_wRR87y-</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2413232073</pqid></control><display><type>article</type><title>Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study</title><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Liow, Ming Han Lincoln ; Goh, Graham S. ; Pang, Hee-Nee ; Tay, Darren Keng-Jin ; Chia, Shi-Lu ; Lo, Ngai-Nung ; Yeo, Seng-Jin</creator><creatorcontrib>Liow, Ming Han Lincoln ; Goh, Graham S. ; Pang, Hee-Nee ; Tay, Darren Keng-Jin ; Chia, Shi-Lu ; Lo, Ngai-Nung ; Yeo, Seng-Jin</creatorcontrib><description>Introduction
With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. The aim of this study was to determine if there were differences in functional and HRQoL measures between older patients (≥ 75 years) and younger controls (< 75 years) undergoing primary UKA.
Materials and methods
Prospectively collected registry data of 1041 patients who underwent primary, cemented, fixed-bearing medial UKA at a single institution from 2002–2013 were reviewed. Propensity scores generated using logistic regression was used to match older patients (≥ 75 years,
n
= 94) to controls (< 75 years,
n
= 188) in a 1:2 ratio. Knee Society Scores, Oxford Knee Score, Short Form-36, satisfaction/expectation scores, proportion of patients attaining OKS/SF-36 PCS MCID and survivorship were analysed.
Results
Patients ≥ 75 years had significantly lower KSFS (67.1 ± 17.9 vs 79.4 ± 18.2,
p
< 0.001) and SF-36 PCS (47.3 ± 10.1 vs 50.4 ± 9.1,
p
= 0.01) as compared to the control group. In addition, a significantly lower proportion of patients ≥ 75 years attained MCID for SF-36 PCS when compared to the controls (50.0% vs 63.8%,
p
= 0.04). Survival rates at mean 8.3 ± 3.0 years were 98.9% (95% CI, 96.7–100) in the older group versus 92.8% (95% CI, 86.8–98.8) in the younger group (
p
= 0.31).
Conclusions
Our findings highlight the need to counsel older patients regarding potentially reduced improvements in functional outcomes, despite advantages of lower revision. However, UKA in older patients continues to be a viable option for isolated medial compartment osteoarthritis
Level of evidence
Level III Propensity score matched study</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03440-4</identifier><identifier>PMID: 32306091</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthritis ; Cost analysis ; Demographics ; Joint replacement surgery ; Knee ; Knee Arthroplasty ; Life expectancy ; Life Sciences & Biomedicine ; Medicine ; Medicine & Public Health ; Oldest old people ; Orthopedics ; Osteoarthritis ; Range of motion ; Science & Technology ; Surgery ; Surgical techniques</subject><ispartof>Archives of orthopaedic and trauma surgery, 2020-07, Vol.140 (7), p.949-956</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>12</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000527501400002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-daf53c7b3fa0136cecf39e7b3fdd80a54ff07949866eebae1b9886da646e1a593</citedby><cites>FETCH-LOGICAL-c375t-daf53c7b3fa0136cecf39e7b3fdd80a54ff07949866eebae1b9886da646e1a593</cites><orcidid>0000-0002-7337-3321</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03440-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03440-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32306091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liow, Ming Han Lincoln</creatorcontrib><creatorcontrib>Goh, Graham S.</creatorcontrib><creatorcontrib>Pang, Hee-Nee</creatorcontrib><creatorcontrib>Tay, Darren Keng-Jin</creatorcontrib><creatorcontrib>Chia, Shi-Lu</creatorcontrib><creatorcontrib>Lo, Ngai-Nung</creatorcontrib><creatorcontrib>Yeo, Seng-Jin</creatorcontrib><title>Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>ARCH ORTHOP TRAUM SU</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. The aim of this study was to determine if there were differences in functional and HRQoL measures between older patients (≥ 75 years) and younger controls (< 75 years) undergoing primary UKA.
Materials and methods
Prospectively collected registry data of 1041 patients who underwent primary, cemented, fixed-bearing medial UKA at a single institution from 2002–2013 were reviewed. Propensity scores generated using logistic regression was used to match older patients (≥ 75 years,
n
= 94) to controls (< 75 years,
n
= 188) in a 1:2 ratio. Knee Society Scores, Oxford Knee Score, Short Form-36, satisfaction/expectation scores, proportion of patients attaining OKS/SF-36 PCS MCID and survivorship were analysed.
Results
Patients ≥ 75 years had significantly lower KSFS (67.1 ± 17.9 vs 79.4 ± 18.2,
p
< 0.001) and SF-36 PCS (47.3 ± 10.1 vs 50.4 ± 9.1,
p
= 0.01) as compared to the control group. In addition, a significantly lower proportion of patients ≥ 75 years attained MCID for SF-36 PCS when compared to the controls (50.0% vs 63.8%,
p
= 0.04). Survival rates at mean 8.3 ± 3.0 years were 98.9% (95% CI, 96.7–100) in the older group versus 92.8% (95% CI, 86.8–98.8) in the younger group (
p
= 0.31).
Conclusions
Our findings highlight the need to counsel older patients regarding potentially reduced improvements in functional outcomes, despite advantages of lower revision. However, UKA in older patients continues to be a viable option for isolated medial compartment osteoarthritis
Level of evidence
Level III Propensity score matched study</description><subject>Arthritis</subject><subject>Cost analysis</subject><subject>Demographics</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Knee Arthroplasty</subject><subject>Life expectancy</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oldest old people</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Range of motion</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Surgical techniques</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc-K1TAUxosoznX0BVxIwI0g1ZM_TZuVDBf_wYALdV3S9PTejm1Tk5Sh-DI-i0_muXYcwYW4SfKF33dycr4se8zhBQcoX0YABSIHATlIpSBXd7IdV1Ll0nB9N9uBkTqvoOBn2YMYrwC4qAzcz86kkKDB8F327ePRL0PLZpt6nFJk9oAtK4sf31e0ITIfmB9aDGyZaD14NmLb24Fk7_w425BGstHFlwmRkTwGPw82pvUVu2AzCZxin1YWnQ-Yjza5Iz0Q09KuD7N7nR0iPrrZz7PPb15_2r_LLz-8fb-_uMydLIuUt7YrpCsb2VngUjt0nTR40m1bgS1U10FplKm0Rmws8sZUlW6tVhq5LYw8z55tdamdrwvGVI99dDgMdkK_xFpII5RWpVSEPv0LvfJLmKi7WihOYxNQSqLERrngYwzY1XPoRxvWmkN9iqbeoqkpmvpXNPWp9JOb0ktDQ7y1_M6CgGoDrrHxXXSUh8NbDAAKURbAFZ1A7PtEiflp75cpkfX5_1uJlhsdiZgOGP588h_9_wRR87y-</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Liow, Ming Han Lincoln</creator><creator>Goh, Graham S.</creator><creator>Pang, Hee-Nee</creator><creator>Tay, Darren Keng-Jin</creator><creator>Chia, Shi-Lu</creator><creator>Lo, Ngai-Nung</creator><creator>Yeo, Seng-Jin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7337-3321</orcidid></search><sort><creationdate>20200701</creationdate><title>Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study</title><author>Liow, Ming Han Lincoln ; Goh, Graham S. ; Pang, Hee-Nee ; Tay, Darren Keng-Jin ; Chia, Shi-Lu ; Lo, Ngai-Nung ; Yeo, Seng-Jin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-daf53c7b3fa0136cecf39e7b3fdd80a54ff07949866eebae1b9886da646e1a593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Arthritis</topic><topic>Cost analysis</topic><topic>Demographics</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Knee Arthroplasty</topic><topic>Life expectancy</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oldest old people</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Range of motion</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Surgical techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liow, Ming Han Lincoln</creatorcontrib><creatorcontrib>Goh, Graham S.</creatorcontrib><creatorcontrib>Pang, Hee-Nee</creatorcontrib><creatorcontrib>Tay, Darren Keng-Jin</creatorcontrib><creatorcontrib>Chia, Shi-Lu</creatorcontrib><creatorcontrib>Lo, Ngai-Nung</creatorcontrib><creatorcontrib>Yeo, Seng-Jin</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liow, Ming Han Lincoln</au><au>Goh, Graham S.</au><au>Pang, Hee-Nee</au><au>Tay, Darren Keng-Jin</au><au>Chia, Shi-Lu</au><au>Lo, Ngai-Nung</au><au>Yeo, Seng-Jin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><stitle>ARCH ORTHOP TRAUM SU</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>140</volume><issue>7</issue><spage>949</spage><epage>956</epage><pages>949-956</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. The aim of this study was to determine if there were differences in functional and HRQoL measures between older patients (≥ 75 years) and younger controls (< 75 years) undergoing primary UKA.
Materials and methods
Prospectively collected registry data of 1041 patients who underwent primary, cemented, fixed-bearing medial UKA at a single institution from 2002–2013 were reviewed. Propensity scores generated using logistic regression was used to match older patients (≥ 75 years,
n
= 94) to controls (< 75 years,
n
= 188) in a 1:2 ratio. Knee Society Scores, Oxford Knee Score, Short Form-36, satisfaction/expectation scores, proportion of patients attaining OKS/SF-36 PCS MCID and survivorship were analysed.
Results
Patients ≥ 75 years had significantly lower KSFS (67.1 ± 17.9 vs 79.4 ± 18.2,
p
< 0.001) and SF-36 PCS (47.3 ± 10.1 vs 50.4 ± 9.1,
p
= 0.01) as compared to the control group. In addition, a significantly lower proportion of patients ≥ 75 years attained MCID for SF-36 PCS when compared to the controls (50.0% vs 63.8%,
p
= 0.04). Survival rates at mean 8.3 ± 3.0 years were 98.9% (95% CI, 96.7–100) in the older group versus 92.8% (95% CI, 86.8–98.8) in the younger group (
p
= 0.31).
Conclusions
Our findings highlight the need to counsel older patients regarding potentially reduced improvements in functional outcomes, despite advantages of lower revision. However, UKA in older patients continues to be a viable option for isolated medial compartment osteoarthritis
Level of evidence
Level III Propensity score matched study</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32306091</pmid><doi>10.1007/s00402-020-03440-4</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7337-3321</orcidid></addata></record> |
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| subjects | Arthritis Cost analysis Demographics Joint replacement surgery Knee Knee Arthroplasty Life expectancy Life Sciences & Biomedicine Medicine Medicine & Public Health Oldest old people Orthopedics Osteoarthritis Range of motion Science & Technology Surgery Surgical techniques |
| title | Should patients aged 75 years or older undergo medial unicompartmental knee arthroplasty? A propensity score-matched study |
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