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Younger patients report greater improvement in self-reported function after knee joint replacement.

STUDY DESIGN
Retrospective chart review.


OBJECTIVES
To evaluate and compare the relationship between patients' age and the change in Oxford Knee Score from preoperative to postoperative assessments, and to investigate whether there is a relationship between preoperative Oxford Knee Score results and the indication for total knee replacement surgery, and if age affects this relationship.


BACKGROUND
An increasing number of younger patients receive knee joint replacements, yet it is unknown how this cohort functions after surgery. This warrants investigation into the potential age-related differences in joint function following surgery. The Oxford Knee Score has been validated as a clinical tool but has yet to be accepted in the decision-making process regarding the need for, or appropriateness of, total knee replacement.


METHODS
In a retrospective chart review, 240 patients completed the Oxford Knee Score questionnaire to evaluate chronic pain and/or dysfunction associated with the knee.


RESULTS
The largest improvement with joint replacement was observed to occur in the youngest patient group (50-59 years old). Moreover, the Oxford Knee Score was shown to be the strongest predictor (odds ratio = 0.61) for the indicated intervention when compared to other predictors. The youngest patient group reported a significantly (P<.03) higher Oxford Knee Score result when indicated for surgery, compared to the oldest patient group (80-89 years old).


CONCLUSION
The results provide insight into how age influences self-perceived joint function before and after joint replacement surgery, and into the clinical decision to provide the surgical option to younger patients. Moreover, the observed relationship between the Oxford Knee Score and the indicated treatment supports the use of the questionnaire as a preoperative tool in considering treatment options for patients with knee osteoarthritis.


LEVEL OF EVIDENCE
Prognosis, level 2b.