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. Kennedy
  • Linda Johnston
  • Lynda Cochrane
  • Petros J. Boscainos
Clinical Research

DOI: 10.1007/s11999-013-2803-3

Cite this article as:
Kennedy, J.W., Johnston, L., Cochrane, L. et al. Clin Orthop Relat Res (2013) 471: 1964. doi:10.1007/s11999-013-2803-3



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.

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • John W. Kennedy
    • 1
    • 2
  • Linda Johnston
    • 3
  • Lynda Cochrane
    • 4
  • Petros J. Boscainos
    • 5
    • 6
  1. 1.The Western InfirmaryGlasgowUK
  2. 2.The Western Infirmary & University of Glasgow School of MedicineGlasgowUK
  3. 3.Tayside Orthopaedic and Rehabilitation Technology CentreUniversity of DundeeDundeeUK
  4. 4.Dundee Epidemiology and Biostatistics UnitUniversity of DundeeDundeeUK
  5. 5.Department of OrthopaedicsPerth Royal InfirmaryPerthUK
  6. 6.Ninewells Hospital & School of MedicineUniversity of DundeeDundeeUK

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