Age-related Difference In Perceived Pain, Health Status, And Fall Risk Following Total Knee Replacement

Abstract

INTRODUCTION: Significant improvements in pain and function have been reported following successful total knee replacement (TKR); however, patients continue to demonstrate persistent balance impairments, increasing the risk of falls and injuries. National joint replacement registries have reported a substantial growth in younger knee osteoarthritic patients (<60 yrs) undergoing TKR, but this younger TKR population is generally understudied. Age-related differences have been previously reported for gait, balance recovery responses, and perceived knee function, distinguishing younger TKR patient from the typical, older TKR patients. PURPOSE: To investigate if age-related difference in perceived pain and health status exist following total knee replacement. METHODS: Thirty-six unilateral TKR patients (18 younger TKR patients: 57.1±4.6 yrs; 32.5±4.1 kg/m2 and 18 older TKR patients: 74.5±6.6 yrs; 31.8±3.5 kg/m2), following TKR surgery took part in the study. Each patient completed the following questionnaires: The Activities-Specific Balance Confidence (ABC), the Oxford Knee Score (OKS), and the Short Form-36 (SF-36). The Timed Up and Go (TUG) test and self-reported number of falls in the previous 12-months were also collected. RESULTS: The younger TKR patients reported higher balance confidence (88.4±11.2 v. 73.7±11.7) and functional mobility (9.2±2.1 v. 13.5±3.8 sec), as well as less falls (1.4±0.2 v. 4.2±1.7), compared to the older TKR patients (p < 0.05). The younger TKR patients also reported less perceived knee pain when completing tasks of daily living (18.2.4±3.2 v. 12.7±3.7:OKS subset for pain) and higher overall health-related quality of life (76.7.4±1.2 v. 68.7±1.7) than reported by the older TKR patients (p < 0.05). DISCUSSION: The younger TKR patients are at reduced risk (higher balance confidence and functional mobility) of falling and reported less falls than the older TKR patients. The age-related differences in perceived knee pain and health-related quality of life following TKR suggest a patient’s age should be a factor when deciding the intervention protocol strategies used for rehabilitation following TKR. Future research should investigate potential age-specific intervention protocol strategies, including pain management and psychomotor training.