[Elective total hip prosthesis management in patients over 80 years of age]

Ninety-five primary elective total hip prosthesis procedures were carried out in patients over 80 years of age (average 82.9 years). The results were studied retrospectively to determine the individual risk-advantage relationship and the general cost-advantage relationship taking the social aspects into consideration. Fractures and emergency procedures were excluded. Ninety-three percent of the patients had preexisting general illnesses. There were no local or general complications in the peri- and postoperative courses of 86% and 85%, respectively. The general complications included urological (6%), cardiovascular (5%) and abdominal (3%) problems. The only death (myocardial infarction) took place 4 weeks after the operation during the rehabilitation phase. The average hospital stay was 23.3 days; 20% of the patients were then able to return home, while 80% were sent to another institution for further care (geriatric department, rehabilitation), where the average stay was 36.7 days. The total inpatient treatment period was on average 52.3 days. At the time of the last follow-up, an average of 4.6 years postoperatively, 75% of the patients were alive with an average age of 87.4 years. Seventy-nine percent were still able to live alone and look after themselves; 81% were independent or only partially dependent (living in a retirement home). Ninety-three percent had no pain or only mild pain. If indicated, the operation risk factor for total hip prostheses in patients over 80 years is obviously low, and the results are good. This operation permits the patient to have many years free of pain, to remain independent, and to achieve a clearly higher quality of life. In this way one can also save on the high cost of many years of nursing care.