title: Total knee arthroplasty in elderly patients. Comparison of tibial component designs.
abstract: The authors examined 98 total knee arthroplasties in 73 patients who were 80 years of age or older at the time of surgery (average, 82 years; range, 80-90 years). The follow-up period averaged 4.5 years (range, 2-12 years). The patients were divided into two groups based on their tibial component design. There were 38 all-polyethylene tibial components in 28 patients and 60 metal-backed tibial components in 45 patients. There were 61 (62%) excellent, 30 (31%) good, 2 (2%) fair, and 5 (5%) poor results. Three of the five poor results required revision for septic failure. Of the knees with an all-polyethylene tibial component, 20 (53%) were rated as excellent, 15 (39%) as good, and 3 (8%) as poor. One of these knees rated as poor required revision for septic failure. The knees with a metal-backed tibial tray had 41 (68%) rated as excellent, 15 (25%) as good, 2 (3%) as fair, and 2 (3%) as poor. Both of the knees with poor results required revision for septic failure. Stratifying the results by component composition revealed 97% survival for both types of tibial trays. These results were obtained at 12 years for the all-polyethylene components and at 8 years for the metal-backed prosthesis. In conclusion, the authors believe that total knee arthroplasty is a reliable and durable procedure in the treatment of knee arthritis in the elderly. Elderly patients may represent a special case because they are generally less active than younger patients and may place less stress on their prosthesis.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Scott, Kelly Orthopaedic Institute, New York, New York.
authors.forename: J L
authors.initials: JL
authors.lastname: L'Insalata
authors.forename: S H
authors.initials: SH
authors.lastname: Stern
authors.forename: J N
authors.initials: JN
authors.lastname: Insall
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008670:Metals; D011095:Polyethylenes; D011474:Prosthesis Design; D011475:Prosthesis Failure
chemical_list: D008670:Metals; D011095:Polyethylenes