Primary total hip arthroplasty outcomes in octogenarians

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Value-Based Healthcare

Background:

• The aging population is increasing the demand for total hip arthroplasty (THA) among octogenarians.
• Assessing outcomes in this demographic is crucial for value-based healthcare systems.
• Understanding the safety and efficacy of THA in older adults is essential.

Purpose of the Study:

• To compare the outcomes of elective primary THA in patients aged 80 years and older (older cohort) versus those younger than 80 (younger cohort).
• To evaluate perioperative complications, readmission rates, and patient-reported outcomes (PROs) between the two age groups.

Main Methods:

• A retrospective review of 10,251 consecutive THA cases from 2011 to 2019.
• Collected data included demographic information, American Society of Anesthesiologists (ASA) scores, Charlson Comorbidity Index (CCI) scores, readmission data, complication rates, and Hip disability and Osteoarthritis Outcome Score (HOOS) PROs.

Main Results:

• The older cohort (mean age 84.25) had higher ASA and CCI scores, indicating greater surgical risk.
• Despite longer hospital stays for the older cohort, there were no significant differences in 90-day emergency visits or major complications like myocardial infarctions, periprosthetic joint infections, dislocations, or aseptic failure.
• The younger cohort experienced higher 90-day readmission rates (3.88% vs 2.18%), and both groups showed similar 12-week and one-year HOOS scores.

Conclusions:

• Octogenarians undergoing elective THA have comparable perioperative complication rates and patient-reported outcome scores to younger patients.
• Despite a higher comorbidity burden, THA is a safe and successful procedure for patients aged 80 and older.
• These findings support the consideration of elective THA for octogenarians within a value-based care framework.