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New Knee Joints for Those Who are 90-Something

A new study shows seniors over age 90 are helped by a total knee replacement (TKR). The pain relief and increased mobility these patients get makes it worth the effort. Most patients live more than five years after receiving the new knee joint.

Doctors at the Mayo Clinic in Rochester, Minnesota, followed 51 TKRs in adults ages 90 to 102 years old. Most were getting their first knee replacement. A few were having a second surgery to revise a failed first TKR. It's likely that as more and more people live longer, TKRs put in at age 70 will need revision or replacement by the time the patient reaches 90.

Problems during and after the operation are a concern in this group. In this study, the rate of complications was 41 percent for first-time TKRs. Many problems were linked to medical conditions already present. The most common problems were high blood pressure, diabetes, or bleeding ulcers. Patients getting a previous TKR repaired or replaced didn't have any complications.

Results from the operation are also important. The authors report a high rate of patient satisfaction. Everyone reported relief from pain. Three-fourths of the patients could walk without a limp or only a slight limp. This was compared to 71 percent who walked with a marked limp or who couldn't walk at all before the operation. In addition, many more patients were able to go up and down stairs again after TKR.

This study shows total knee revision or replacement can be done safely in patients over 90 years of age. The TKR is durable and reliable. The authors advise a careful exam before the operation. Patients with medical problems can be watched carefully to avoid problems.

References: Mark W. Pagnano, MD, et al. Total Knee Arthroplasty for Patients 90 Years of Age and Older. In Clinical Orthopaedics & Related Research. January 2004. Vol. 418. Pp. 179-183.

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