Functional results in total hip replacement in patients 65 years and older

Total hip arthroplasty in patients 65 years and older has been very durable in long term results. Eighty-nine hips in 79 patients were observed for 5 to 9 years to determine the importance of advancing age and deterioration of activity levels to durability of total hip replacement. The age of patients was 65 years or older at the time of surgery. A classification of function was used that graded activity level. During the average 6.24 years of postoperative followup, 22% of the patients died, 38% had medical problems that reduced their functional level, and 10% reduced their function because of their hip surgery. Hip related deterioration occurred only in those patients with a cementless stem. There was decreasing measured wear with increasing age; otherwise, neither age nor activity change in this study was related to loss of fixation of components, osteolysis, or bone remodeling. Increasing age and decreasing activity in patients 65 years and older does not seem to be the primary reason for durability of total hip arthroplasty in these patients. In this age group, the durability of hip replacement is related mostly to the quality of fixation.