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Lookup NU author(s): Lucy Walker, Michelle Bardgett, James Holland, Professor David Deehan
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© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Introduction: Management of the young patient with end-stage osteoarthritis of the knee is difficult, with surgical options of osteotomy, partial or total knee arthroplasty (TKA). The primary aim of this study was to assess whether age of less than 55 years was an independent predictor of functional outcome and satisfaction after total knee arthroplasty (TKA). The secondary aims were to identify pre-operative differences in patient demographics, comorbidity and function between patients less than 55 years old compared to those 55 years old and over. Materials and methods: A retrospective cohort consisting of 2589 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, comorbidity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year. Regression analysis was used to identify independent pre-operative predictors of change in the WOMAC and SF-12 scores, and patient satisfaction. Results: Patients less than 55 years old were significantly less likely to be satisfied with the overall outcome of their TKA (OR 0.4, p = 0.001). After adjusting for confounding variables age group was not an independent predictor of overall satisfaction with overall outcome (OR 0.71, p = 0.16). Independent predictors of an increased risk of dissatisfaction with the overall outcome at 1 year were depression (OR 0.58, p = 0.008) and worse pre-operative SF-12 MCS (p = 0.04). Conclusion: Age of less than 55 years is not an independent predictor of functional outcome or rate of patient satisfaction after TKA. However, depression and poor mental health are significantly more prevalent in patients less than 55 years old and were independently associated with a lower satisfaction rate.
Author(s): Clement ND, Walker LC, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ
Publication type: Article
Publication status: Published
Journal: Archives of Orthopaedic and Trauma Surgery
Year: 2018
Volume: 138
Issue: 12
Pages: 1755-1763
Print publication date: 01/12/2018
Online publication date: 26/09/2018
Acceptance date: 10/05/2018
ISSN (print): 0936-8051
ISSN (electronic): 1434-3916
Publisher: Springer
URL: https://doi.org/10.1007/s00402-018-3041-7
DOI: 10.1007/s00402-018-3041-7
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