Total joint arthroplasty in the extremely elderly: Hip and knee arthroplasty after entering the 89th year of life☆
Section snippets
Materials and methods
We performed a retrospective review of our records for all patients who had primary or revision total hip arthroplasty (THA) or total knee arthroplasty (TKA) since 1978. Patients who had surgery after their 89th birthday were included in the study. Eighty-three patients with 45 TKAs and 56 THAs were identified for the study.
Data were collected as to postoperative complications; patient and implant survival; revisions; discharge disposition; length of inpatient hospitalization; use of ambulatory
Complications and deaths
The total complication rate was 14%. For TKA, there were 8 perioperative complications, including 1 each of decubitus ulcer, pneumonia, urinary tract infection, fractured patella, ileus, congestive heart failure (CHF), perforated gastric ulcer, and 1 patient who had both a subluxed patella and required a cholecystectomy. For THA, there were 4 complications. This included a single dislocation, 1 recurring dislocation (which did not require additional surgery), 1 fat embolus, and a fourth patient
Discussion
Pain relief and functional improvement occurred in this group of patients; however, a larger percentage of these patients compared with younger patients undergoing total joint arthroplasty required the use of an assist device, which is similar to findings in other studies in the elderly 4, 5, 6, 9, 10, 18, 19. The use of an assist device after surgery decreased from 86% to 72% for THAs and 74% to 51% for TKAs in this study. At 1 year following surgery, the average HHS improved from 38 points
References (20)
- et al.
Total knee arthroplasty in the octogenarian
J Arthroplasty
(1993) - et al.
Revision hip arthroplastycan the octogenarian take it?
J Arthroplasty
(1993) - et al.
Survivorship analysis in the evaluation of joint replacement
J Arthroplasty
(1986) - et al.
Total knee arthroplasty in nonagenarians
J Arthroplasty
(2002) - et al.
Outcome of hip and knee arthroplasty in persons aged 80 years and older
Clin Orthop
(1997) Total hip arthroplasties in the elderly
Clin Orthop
(1992)- et al.
Total hip arthroplasty in patients 80 years of age and older
Clin Orthop
(1992) - et al.
Orthopaedic challenges in an aging Ppopulation
Instruct Course Lect
(1997) - et al.
Total knee arthroplasty in patients 80 years of age and older
Clin Orthop
(1994) - et al.
Outcome and long-term results following total hip replacement in elderly patients
Clin Orthop
(1995)
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No benefits or funds were received in support of this study.