The effect of age on pain, function, and quality of life after total hip and knee arthroplasty

Background: As utilization rates for total joint arthroplasty increase, the re is a hesitancy to perform this surgery on very old patients. The objecti ve of this prospective study was to compare pain, functional, and health-re lated quality-of-life outcomes after total hip and total knee arthroplasty in an older patient group (greater than or equal to 80 years) and a represe ntative younger patient group (55-79 years). Methods: in an inception community-based cohort within a Canadian health ca re system. 454 patients who received primary total hip arthroplasty (n = 19 7) or total knee arthroplast (n = 257) were evaluated within a month prior to surgery and 6 months postoperatively. Pain, function, and health-related quality of life were evaluated with the Western Ontario and McMaster Unive rsities (WOMAC) Osteoarthritis Index and the 36-Item Short-Form Health Surv ey (SF-36). Results: There were no age-related differences in joint pain, function, or quality-of-life measures preoperatively or 6 months postoperatively. Furthe rmore, after adjusting for potential confounding effects, age was not a sig nificant determinant of pain or function. Although those in the order and y ounger groups had comparable numbers of comorbid conditions and complicatio ns, those in the older group were more likely to be transferred to a rehabi litation facility than younger patients. Regardless of age, patients did no t achieve comparable overall physical health when matched with the general population for age and sex. Conclusions: With increasing life expectancy and elective surgery improving quality of life, age alone is not a factor that affects the outcome of joi nt arthroplasty and should not be a limiting factor when considering who sh ould receive this surgery.