Total knee arthroplasty is safe for patients aged ≥80 years in hong kong

Abstract

Introduction: Total knee arthroplasty (TKA) is an efficacious operation that improves pain and function in patients with knee arthritis. Because of the population ageing trend in Hong Kong, there is a need to determine the safety profile of TKA in older patients. This study examined the age of patients who underwent TKA in the past 10 years in Hong Kong; the aim was to investigate the mortality safety profile and clinical outcomes of TKA in patients aged ≥80 years. Methods: This study included all patients who underwent primary TKA in the Hospital Authority (HA) from 2010 to 2019. Incidences of 30-day, 90-day, and 1-year mortality were established. Clinical outcomes of patients aged ≥80 years in one cluster of HA hospitals were assessed. Results: Between 2010 and 2019, 25 040 TKA procedures were conducted in all HA hospitals; 2491 were conducted in patients aged ≥80 years. The median age at operation was higher during 2015-2019 than during 2010-2014 (70 vs 69 years; P<0.001); furthermore, an increase was observed in the proportion of patients aged ≥80 years at the time of operation. Incidences of 30-day, 90-day, and 1-year mortality were 0.156%, 0.35%, and 1.09%, respectively. Conclusions: In this first study to examine the safety profile of TKA in older patients in Hong Kong, the mean age at the time of TKA and proportion of patients aged ≥80 years have steadily risen in the past decade. Even in older patients, TKA is a reasonably safe procedure.

引言：全膝關節置換術（TKR）能有效改善膝關節炎患者的疼痛和功能。隨着香港人口老化，有必要確定TKR在老年患者中的安全性。本研究旨在檢視過去10 年香港不同年齡組別的患者進行TKR的趨勢，並確定80歲或以上患者進行TKR的安全性，包括死亡率以及臨床結果。 方法：包括2010年至2019年期間在醫院管理局（醫管局）接受初次TKR的所有患者，檢視TKR後30天、90天和1年死亡率，並評估醫管局其中一個聯網中80歲或以上患者的臨床結果。 結果：2010年至2019年期間，所有醫管局醫院進行25 040例TKR，其中80歲或以上患者佔2491例。與2010年至2014年的數據相比，2015年至2019年期間接受TKA的患者年齡中位數較高（70歲比69歲；P<0.001）。在這10年期間，80歲或以上患者接受TKA的比例亦有上升趨勢。術後30天、90天和一年內死亡率分別為0.156%、0.35%和1.09%。 結論：這是香港首個有關老年人進行TKR的安全性研究。在過去十 年，80歲或以上患者進行TKR的平均年齡有上升趨勢。研究表明TKR 即使對老年患者也是一種相當安全的手術。