Is age an advantage? Improved outcomes after medial unicompartmental knee arthroplasty in patients aged ≥70 years.

Abstract

To determine whether patients aged ≥ 70 years undergoing medial unicompartmental knee arthroplasty achieve superior clinical outcomes compared with younger patients, addressing the current lack of age-specific evidence in this setting. A retrospective cohort study was conducted, and 1:1 propensity-score matching was employed using the following variables: age, body mass index, Charlson Comorbidity Index, baseline Knee Society Score (KSS), and preoperative visual analogue scale (VAS) for pain. The matched cohort included 76 patients (38 elderly patients aged ≥70 years and 38 younger patients <70 years), all with a minimum of 12 months' follow-up. Primary endpoints were postoperative VAS pain, KSS, and perioperative complications. In the matched cohort, elderly patients had lower postoperative pain (VAS 2.1 ± 2.2 vs. 3.1 ± 2.4; <i>p</i> = 0.037) and higher KSS (82.5 ± 14.5 vs. 73.4 ± 16.9; <i>p</i> = 0.021) than younger patients, while also reporting a higher rate of postoperative satisfaction (97.4% vs. 84.2%; <i>p</i> = 0.049) and fewer complications (2.6% vs. 13.2%; <i>p</i> = 0.048), at a minimum of 12 months' follow-up. In appropriately selected candidates, patients aged ≥ 70 years undergoing medial unicompartmental knee arthroplasty achieve clinical outcomes and satisfaction that are at least comparable-and in several measures superior-to those of younger patients at ≥12 months, supporting age ≥70 years as a viable indication. Level III, retrospective comparative study.