Total knee arthroplasty in the very aged

Twenty-six total knee arthroplasties were performed on 20 patients who were 85 years or older (mean, 87 years). Only those patients with a minimum of 3 years' followup are reported here. One patient died approximately 1 year after surgery, and 4 patients (5 knees) were lost to followup, leaving 20 total knee arthroplasties in 15 patients to be reported. Postoperative results were based on a 100-point scoring system that is a modification of the Knee Society scoring system. Eleven knees received an excellent rating, 4 good, 2 fair, and 3 poor. The primary indication for surgery in this patient population was pain control. Most patients required the continued use of ambulatory assistive devices such as a cane after surgery, but pain relief was good or excellent in 19 of 20 knees and quality of life improved. All patients tolerated the procedure well, with few postoperative complications noted. There was no perioperative mortality, and all wounds healed normally. Total knee arthroplasty is a safe and reliable procedure in the very aged patient for management of pain and deformity secondary to arthritis of the knee.