Knee replacement satisfaction lower among patients under 55

Orthopedic

A new study conducted by faculty at the Worcester-based University of Massachusetts Chan Medical School has found that patients under 55 have less improvement in pain, function and quality of life following total knee arthroplasties when compared to patients 75 and older. 

The study, led by Distinguished Professor of Orthopedics and Physical Rehabilitation David Ayers, MD, analyzed 11,602 patients who underwent arthroplasty in one knee. It broke patients into cohorts by age: under 55, 55 to 64, 65 to 75, and 75 and older. 

The team collected patient data prior to the surgery, three months after and a year after. Information included medical and musculoskeletal comorbidity conditions; patient-reported outcome measures to determine the patients' levels of pain, function and quality of life; and a survey that assessed the overall physical and emotional status of the patient. 

The patients under 55 were, on a whole, more obese than the older patient groups. They also had higher incidences of being smokers and exhibiting other medical conditions. 

The younger patients started with more pain and a lower quality of life pre-surgery than older patients. 

"One of the take-home messages from this study is that it's important for the surgeon and the surgical team to ask all patients — but particularly patients less than 55 — what their expectations are regarding pain and activity level after TKA. The surgeon should set realistic expectations for after surgery, so patients know that their knees are not going to be completely pain free, but it's going to be dramatically better than it was before surgery," Dr. Ayers, who is also the Arthur M. Pappas, MD Chair in Orthopedics at Chan Medical School, said in the report. 

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