Who Reports the Most Pain After Knee Replacement?

After total knee replacement surgery, patients younger than 45 years and those aged 75 years or older seem to report more pain and less activity than their peers.

Researchers from Sinai Hospital’s Rubin Institute reviewed 278 postoperative patients and separated them into 5 age groups to determine whether age affected total knee replacement surgery outcomes. The age groups were categorized as 45 years or younger, 45 to 54 years, 55 to 64 years, 65 to 74 years, and 75 years or older.

Before the procedure and up to 7 years afterwards, patients evaluated their range of motion, pain, and activity levels. The researchers found that the oldest and youngest categories of patients reported more pain and less activity following the procedure, although all patients reported comparable improvement in range of motion.

At 6 weeks and 1 year post-surgery, those aged 75 years or older reported greater pain. These patients and those younger than 45 years reported the lowest activity scores at periods of 3 months, 5 years, and 7 years post-surgery. Those aged 45 years or younger also tended to have lower scores for functional health and wellbeing.

Lead study author Randa Elmallah, MD, told Pharmacy Times that the most surprising finding was that patients aged 75 years and older had higher Knee Society Scoring system scores, while younger patients had lower mental component scores. As far as the pharmacist’s role in postoperative knee replacement management goes, these findings may help pharmacists manage patients’ expectations for pain medications.

“OTC options for pain should follow the recommended guidelines, but it is valuable for pharmacists to be aware that younger patients may have poorer mental component scores and lower improvements in objective scores compared with those who are 75 and older, and this may be related to demand for pain medications,” Dr. Elmallah said. “However, this correlation cannot be drawn from this study, but it may be an interesting point to consider. It is difficult to draw direct correlations to medication use, and thus the role of pharmacists, but it may be important for them to be aware of these outcomes when they encounter post-TKA [total knee arthroplasty] patients.”