Clinical Research

Clinical Orthopaedics and Related Research®

, Volume 471, Issue 6, pp 1964-1969

Total Knee Arthroplasty in the Elderly: Does Age Affect Pain, Function or Complications?

  • John W. KennedyAffiliated withThe Western InfirmaryThe Western Infirmary & University of Glasgow School of Medicine Email author 
  • , Linda JohnstonAffiliated withTayside Orthopaedic and Rehabilitation Technology Centre, University of Dundee
  • , Lynda CochraneAffiliated withDundee Epidemiology and Biostatistics Unit, University of Dundee
  • , Petros J. BoscainosAffiliated withDepartment of Orthopaedics, Perth Royal InfirmaryNinewells Hospital & School of Medicine, University of Dundee

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TKA is one of the most commonly performed procedures in the elderly, yet whether age influences postoperative pain, function, and complication rates is not fully understood for this group. This is because the current literature has limited followup, small sample sizes, and no comparator group.


We therefore asked if increasing age adversely affects postoperative pain, Knee Society Scores©, and complication rates.


We retrospectively reviewed all 438 patients 80 years or older who underwent primary TKA between 1995 and 2005. We established a comparator group of 2754 patients younger than 80 years. We assessed pain, the Knee Society Score© (KSS), and the Knee Society Function Score© (KSFS). The number and type of complications were recorded and those graded 2 or more using the classification of Dindo et al. were analyzed. Minimum followup was 5 years (mean, 6 years; range, 5–15.5 years).


We found no difference in pain scores at 3, 5, and 10 years between the two groups. The KSS was comparable between groups at Year 5, but the KSFS was lower in the octogenarians. Major complications rates were higher in the octogenarian group (19% versus 15%).


When compared with younger patients, octogenarians can expect comparable pain relief and KSS but lower function and more complications.

Level of Evidence

Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.