Dissatisfaction and Residual Symptoms in Younger and Older Adult Patients after Total Knee Arthroplasty

Abstract

Introduction: Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients <60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages <60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.

Methods: Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (<60 years or ≥60 years) for analysis.

Results: In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (<60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer <60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.

Conclusion: Patients younger than 60 years reported less satisfaction with performing normal activities and decreased normal knee function postoperatively. The <60 cohort reported requiring more readmissions for TKA concerns; however, no difference was observed in the rate of revision TKA between the cohorts. This information may be beneficial to clinicians and younger patients when discussing postoperative outcomes and functional expectations following TKA.

Figure 1

Image showing full electronic survey.