The Knee · 2026
Elevated risks of pneumonia, cognitive dysfunction, and cerebrovascular disorder in super-elderly knee arthroplasty patients: insights from a nationwide Japanese database.
СтатьяНазвание и аннотация: Перевод в очереди
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Mori Yu, Tarasawa Kunio, Tanaka Hidetatsu, Kamimura Masayuki, Harada Kento, Mori Naoko, Fushimi Kiyohide, Aizawa Toshimi, Fujimori Kenji
Аннотация
INTRODUCTION: Knee arthroplasty is an effective treatment option for managing advanced osteoarthritis and rheumatoid arthritis, even in elderly patients. However, super-elderly patients face increased risks of postoperative complications such as in-hospital mortality, deep vein thrombosis, pneumonia, cerebrovascular events, and cognitive dysfunction. This study aims to analyze postoperative complications in super-elderly patients (aged 85 years and older) and elderly patients (aged 70-84 years) who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) using Japan's nationwide DPC database. The analysis was conducted after adjusting for confounding factors through propensity score matching.
METHODS: We conducted a retrospective study of 200,925 patients who underwent TKA or UKA between 2016 and 2023. After propensity score matching (1:1) based on age, sex, body mass index, surgical method, and comorbidities, 21,117 patients were included in each group. Postoperative complications, including in-hospital mortality, deep vein thrombosis, pneumonia, cerebrovascular events, and cognitive dysfunction, were analyzed. Multivariate logistic regression identified independent risk factors for postoperative complications.
RESULTS: The super-elderly group exhibited higher odds ratios for pneumonia (2.227, 95% CI: 1.494-3.319), cerebrovascular events (1.720, 95% CI: 1.305-2.266), and cognitive dysfunction (1.767, 95% CI: 1.485-2.103). They also had more extended hospital stays and higher blood transfusion requirements. However, no significant differences were observed for deep vein thrombosis, pulmonary embolism, or in-hospital mortality.
CONCLUSION: Super-elderly patients exhibit increased risks for certain complications, though not for mortality. When clinically appropriate, performing knee arthroplasty before the age of 85 may help reduce these risks.
METHODS: We conducted a retrospective study of 200,925 patients who underwent TKA or UKA between 2016 and 2023. After propensity score matching (1:1) based on age, sex, body mass index, surgical method, and comorbidities, 21,117 patients were included in each group. Postoperative complications, including in-hospital mortality, deep vein thrombosis, pneumonia, cerebrovascular events, and cognitive dysfunction, were analyzed. Multivariate logistic regression identified independent risk factors for postoperative complications.
RESULTS: The super-elderly group exhibited higher odds ratios for pneumonia (2.227, 95% CI: 1.494-3.319), cerebrovascular events (1.720, 95% CI: 1.305-2.266), and cognitive dysfunction (1.767, 95% CI: 1.485-2.103). They also had more extended hospital stays and higher blood transfusion requirements. However, no significant differences were observed for deep vein thrombosis, pulmonary embolism, or in-hospital mortality.
CONCLUSION: Super-elderly patients exhibit increased risks for certain complications, though not for mortality. When clinically appropriate, performing knee arthroplasty before the age of 85 may help reduce these risks.