Evaluating Total Hip Arthroplasty in Nonagenarians
(HealthDay News) — Nonagenarian patients can safely undergo a total hip arthroplasty (THA), according to a study presented at the annual meeting of the American Academy of Orthaopedic Surgeons, held from March 11–15 in New Orleans.
Alexander Miric, MD, from Kaiser Permanente in Los Angeles, and colleagues retrospectively analyzed prospectively collected data included in the Total Joint Replacement Registry to identify all 43,543 of the elective, primary THAs (April 1, 2001–Dec. 31, 2011). The authors compared patient characteristics, comorbidities, general health, and postoperative outcomes for those aged ≥90 years, <80 years, and 80–89 years.
The researchers found that 0.4% (183 procedures) of the primary THAs performed were on nonagenarians. Nonagenarians had the highest prevalence of American Society of Anesthesiologist scores ≥3, peripheral vascular disease, hypertension, and valvular disease (P<0.001), compared to patients <80 and 80–89 years old, but the lowest body mass index (P<0.001) and the lowest prevalence of diabetes (P<0.05). Nonagenarian length of stay was the longest, although comparable to patients 80–89 years, and they had the highest incidence of death within 90 days (both P<0.001). The incidence of deep vein thrombosis was lowest in nonagenarian patients, as was readmission within 90 days (both P<0.001).
"Despite advanced age and a higher prevalence of some comorbidities, our sample of nonagenarians experienced a complication rate comparable to those of younger THA patients," Miric and colleagues conclude.