TOTAL KNEE ARTHROPLASTY IN THE OCTOGENARIAN

Fifty consecutive Miller-Galante (Zimmer, Warsaw, IN) and Kinematic II (Howmedica, Rutherford, NJ) total knee arthroplasties for osteoarthri tis in patients 80 years of age and over were compared to 50 arthropla sties in patients aged 65-69 years, with a minimum 2-year follow-up pe riod. Each patient was assessed clinically using the Hospital for Spec ial Surgery knee rating scores and radiographically by an independent observer. Average age of the study group participants was 83 years and of the comparison group, 68 years. Apart from age, the two groups wer e similar with respect to sex, bilaterality, prosthetic type, and preo perative Hospital for Special Surgery scores. No significant differenc es were noted for pain, functional level, strength, stability, or rang e of motion throughout the 2-year follow-up period. More octogenarian patients were found to have a preoperative deformity, and these deform ities were larger, on average, than in the retiree group, suggesting a more advanced disease pathophysiology. A larger number of elderly pat ients required continued use of walking aids. An analysis of the cost- effectiveness data, collected for both groups, showed that although th e in-hospital costs and length of stay were the same ($17,160 Can), th e cost per patient after discharge was slightly greater ($2,000 Can) i n the octogenarian. This prospective clinical study of total knee arth roplasties for osteoarthritis has shown that it is a reliable and cost -effective procedure for the octogenarian.