Skip to main content
Log in

Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: The purpose of the present cross-sectional study was to analyze how knee replacement affects performance in activities of daily living (ADL), mobility, and pain in older patients with knee osteoarthritis. Methods: Knee osteoarthritis patients aged ≧75 years scheduled for knee replacement (Group 0, n=68), or having undergone knee replacement one (Group 1, n=71) or two years (Group 2, n=75) earlier, were sent a questionnaire asking about ADL performance, mobility, degree of pain, use of analgesics, and patient’s perception of the outcome. Results: More patients having had knee replacement than those waiting for surgery reported they were able to perform ADLs without difficulty, the exception being bathing and dressing/undressing. They also had a better performance in mobility measures (ability to move indoors and use stairs, walking distance). After adjustment for age, gender, and anesthesiological risk score, the patients in Groups 1 and 2 continued to show better performance than the patients in Group 0 in rising from chair, heavy housework, moving indoors, using stairs, and walking 400 m. Ninety-three percent of patients in Group 0 but only 23% and 34% in Groups 1 and 2 used analgesics for knee pain. The majority of the patients in Groups 1 and 2 were satisfied with the outcome and estimated that their health and mobility had improved after surgery. Conclusions: Knee osteoarthritis patients aged ≧75 years, having undergone knee replacement, have not only less pain and better mobility but also superior ADL performance than patients scheduled for surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Dillon C, Rasch E, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United states: Arthritis data from the third national health and nutrition examination survey 1991–94. J Rheumatol 2006; 33: 2271–79.

    PubMed  Google Scholar 

  2. Talmo C, Robbins C, Bono J. Total Joint Replacement in the Elderly Patient. Clin Geriatr Med 2010; 26: 517–29.

    Article  PubMed  Google Scholar 

  3. Guccione AA, Felson DT, Anderson JJ et al. The effect of specific medical conditions on the function limitations of elders in the Framingham study. Am J Public Health 1994; 84: 351–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Song J, Chang RW, Dunlop DD. Population impact of arthritis on disability in older adults. Arthritis Rheum 2006; 55: 248–55.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jakobsson U, Hallberg IR. Quality of life among older adults with osteoarthritis: an explorative study. J Gerontol Nurs 2006; 32: 51–60.

    Article  PubMed  Google Scholar 

  6. Jordan KM, Arden NK, Doherty M et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003; 62: 1145–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Ethgen O, Bruyère O, Richy F, Derdennes C, Reginster Y. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 2004; 86: 963–74.

    Article  PubMed  Google Scholar 

  8. Zhang W, Moskowitz RW, Nuki G et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008; 16: 137–62.

    Article  CAS  PubMed  Google Scholar 

  9. Laskin R. Total knee replacement in patients older than 85 years. Clin Orthop Relat Res 1999; 367: 43–9.

    Google Scholar 

  10. March LM, Cross MJ, Lapsley H et al. Outcomes after hip or knee replacement surgery for osteoarthritis: a prospective cohort study comparing patients quality of life before and after surgery with age-related population norms. Med J Aust 1999; 171: 235–8.

    Article  CAS  PubMed  Google Scholar 

  11. Fitzgerald JD, Orav EJ, Lee TH et al. Patient quality of life during the 12 months following joint replacement surgery. Arthritis Rheum 2004; 51: 100–9.

    Article  PubMed  Google Scholar 

  12. Dahm D, Barnes S, Harrington J. Patient-reported activity level after total knee arthroplasty. J Arthroplasty 2008; 23: 401–7.

    Article  PubMed  Google Scholar 

  13. George L, Ruiz D, Sloan F. The effect of total knee arthroplasty on physical functioning in the older population. Arthritis Rheum 2008; 58: 3166–71.

    Article  PubMed  Google Scholar 

  14. Bourne R, Chesworth B, Davis A. Patient satisfaction after total knee arthroplasty. Clin Orthop Relat Res 2010; 468: 57–63.

    Article  PubMed  Google Scholar 

  15. Hamel MB, Toth M, Legedza A, Rosen MP. Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee. Arch Intern Med 2008; 168: 1430–40.

    Article  PubMed  Google Scholar 

  16. Seeman TE, Merkin SS, Crimmins EM, Karlamangla AS. Disability trends among older Americans: National Health And Nutrition Examination Surveys, 1988–1994 and 1999–2004. Am J Public Health 2010; 100: 100–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sainio P, Koskinen S, Heliövaara M, et al. Self-reported and testbased mobility limitations in a representative sample of Finns aged 30+. Scand J Public Health 2006; 34: 378–86.

    Article  PubMed  Google Scholar 

  18. Guralnik JM, Ferrucci L, Pieper CF et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55: M221–31.

    Article  CAS  PubMed  Google Scholar 

  19. Hardy SE, Kang Y, Studenski SA, Degenholtz HB. Ability to walk 1/4 mile predicts subsequent disability, mortality, and health care costs. J Gen Intern Med 2011; 26: 130–5.

    Article  PubMed  Google Scholar 

  20. Ferrucci L, Guralnik JM, Kasper J et al. Constant hierarchic patterns of physical functioning across seven populations in five countries. Gerontologist 1998; 38: 286–94.

    Article  CAS  PubMed  Google Scholar 

  21. Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM, for the Womens Health and Aging Study. J Clin Epidemiol 1999; 52: 27–37.

    Article  CAS  PubMed  Google Scholar 

  22. Young Y, Boyd CM, Guralnik JM, Fried LP. Does self-reported function correspond to objective measures of functional impairment? J Am Med Dir Assoc 2010; 11: 645–53.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; 248: 13–14.

    Article  Google Scholar 

  24. Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB; Kinemax Outcomes Group. Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC. J Bone Joint Surg Am 2001; 83: 1856–64.

    Article  CAS  PubMed  Google Scholar 

  25. Owens WD, Felts JA, Spitznagel EL. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978; 49: 239–43.

    Article  CAS  PubMed  Google Scholar 

  26. Sloan F, Ruiz D, Platt A. Changes in functional status among persons over age sixty-five undergoing total knee arthroplasty. Med Care 2009; 47: 742–8.

    Article  PubMed  Google Scholar 

  27. Collerton J, Davies K, Jagger C et al. Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study. Br Med J 2009; 339: b4904.

    Article  Google Scholar 

  28. O’Connor MI. Implant survival, knee function, and pain relief after TKA: are there differences between men and women? Clin Orthop Relat Res 2011; 469: 1846–51.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Puolakka P, Rorarius MG, Roviola M, Puolakka TJ, Nordhausen K, Lindgren L. Persistent pain following knee arthroplasty. Eur J Anasthesiol 2010; 27: 455–60.

    Article  Google Scholar 

  30. Baker P, van der Meulen JH, Lewsey J, Gregg PJ, National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. J Bone Joint Surg Br 2007; 89: 893–900.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Esa Jämsen MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Limnell, K., Jämsen, E., Huhtala, H. et al. Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study. Aging Clin Exp Res 24, 699–706 (2012). https://doi.org/10.1007/BF03654846

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03654846

Key words

Navigation