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Revision total hip arthroplasty in octogenarians. A case-control study
Javad Parvizi1, Aidin Eslam Pour, Nahid R Keshavarzi
1Rothman Institute, 925 Chestnut Street, Philadelphia, PA 19107, USA. Parvj@aol.com
The Journal of Bone and Joint Surgery. American Volume
|December 7, 2007
Summary
Revision total hip arthroplasty offers significant benefits for patients over eighty years old. While mortality is higher, medical complication rates are similar to younger patients, with fewer dislocations.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Arthroplasty Research
Background:
- Revision total hip arthroplasty (RTHA) in the very elderly is perceived to have high complication rates.
- This study evaluates early outcomes and complications of RTHA in octogenarians.
Purpose of the Study:
- To assess the safety and efficacy of RTHA in patients over 80 years old.
- To compare outcomes and complication rates between octogenarians and a younger control group.
Main Methods:
- Retrospective review of 170 RTHA procedures in 159 octogenarians (mean age 83.8) and 170 RTHA in younger patients (≤70 years).
- Comparison of functional outcomes (Harris hip score) and quality of life (SF-36).
- Analysis of risk factors for complications and mortality using Kaplan-Meier survivorship analysis.
Main Results:
- Octogenarians showed significant Harris hip score improvement (47 to 85), comparable to the control group (44.3 to 87.9).
- Mortality rate was significantly higher in octogenarians (58.8%) versus controls (7.1%).
- Medical complication rates were similar (22.4% vs 15.3%), but dislocations were lower in octogenarians (p=0.01).
Conclusions:
- RTHA provides substantial clinical benefits for patients over eighty.
- Medical complication rates in octogenarians may not be significantly higher than in younger patients.
- Technical complications and dislocations are less prevalent in octogenarians compared to younger RTHA patients.
