Comparison of Revision Rate and Complications of Total Knee Arthroplasty Between Filipino Octogenarians and Their Age-Appropriate Controls

Introduction. Total knee arthroplasty (TKA) is a surgical intervention for treatment of end-stage knee arthritis. This retrospective study aims to describe and compare the complications and revision rate of total knee arthroplasty in Filipino octogenarians (age 80 and above) and age-appropriate controls (age 70 and below). 

Methodology. All patients who underwent TKA at a single tertiary hospital from January 2011- March 2021 were included. Patients were then classified into two groups: octogenarian and non-octogenarian. The following patients were excluded in the study: non-Filipino, patients aged 70-79 years at time of surgery and patients with incomplete hospital data. Demographic data, preoperative comorbidities, blood transfusion, length of hospital stay, complications (including readmission and mortality within 90 days from surgery) and revision surgery were obtained from the patients’ hospital records and compared. 

Results. A total of 58 subjects were included: 15 subjects (26.3%) classified under the Octogenarian group (mean: 82 years, 80-88 years) and 43 subjects (mean age: 60 years, 48-69y years) belonged to the Non Octogenarian group. The two groups were similar with respect to sex, BMI, American Society of Anesthesiologists (ASA) preoperative status and preoperative comorbidities. Octogenarians stayed at the hospital for an average of 6.57 days while non octogenarians stayed for an average of 7.7 days (p = 0.4041). 33.3% of the octogenarians had blood transfusion in comparison to 13.9% among the non-octogenarians (p = 0.4728).  The following complications within 90 days from surgery were noted: readmissions (2), pneumonia (2) and deep vein thrombosis (1) – all of which are from the Octogenarian group. Only 1 (from Octogenarian group) underwent revision surgery for infection. No mortalities noted from both groups. 

Conclusion. Total knee arthroplasty has an overall low complication rate, even among Filipino octogenarians. There is no significant difference in terms of blood transfusion and length of hospital when compared to their age-appropriate controls.  However, a significantly higher revision rate and readmission within 90 days from surgery is observed and should be discussed preoperatively with Filipino octogenarians who are indicated and amenable for the elective surgery. 

Keywords: total knee arthroplasty, octogenarian, 90-day complications, revision rate, Filipino