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Cementless Total Hip Arthroplasty in Octogenarians.

Christoph Stihsen1, Bernhard Springer1, Elena Nemecek1

  • 1Department of Orthopaedic Surgery, Medical University of Vienna, Vienna, Austria.

The Journal of Arthroplasty
|March 15, 2017
PubMed
Summary

Cementless total hip arthroplasty shows excellent implant survival in patients over 80. However, octogenarians face a higher complication rate, particularly early postoperative issues, with osteoporosis being a significant risk factor.

Keywords:
cementlesscomplicationsoctogenariansoutcometotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Geriatric Medicine
  • Biomaterials Science

Background:

  • Controversy exists regarding cementless implants in elderly patients.
  • This study evaluates cementless total hip arthroplasty (THA) outcomes in patients over 80.
  • Focus is on primary osteoarthritis of the hip in octogenarians.

Purpose of the Study:

  • To assess the efficacy and safety of cementless THA in patients aged over 80.
  • To compare implant survival and complication rates between octogenarian and younger patient groups.
  • To identify risk factors influencing outcomes in elderly THA patients.

Main Methods:

  • Retrospective analysis of 162 cementless THAs in octogenarians (mean age 83).
  • Comparison with a control group of 342 younger patients (mean age 65).
  • Median follow-up of 128.4 months, with competing risk analyses for implant survival.

Main Results:

  • Cumulative implant survival was high (98.1% at 5 & 10 years) in octogenarians, comparable to younger controls.
  • No significant difference in system exchange rates between groups.
  • Octogenarian group showed significantly worsened complication-free survival, with early postoperative complications being more frequent.

Conclusions:

  • Cementless THA is a viable option for elderly patients, offering excellent implant survival.
  • Octogenarians experience a higher overall complication rate, influenced by early postoperative issues.
  • Osteoporosis is a major risk factor for complications in this age group, requiring surgeon awareness.