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High 1-year survival rate found after THA in patients older than 90 years
The duration of stay was at 24.72 days for patients older than 90 years vs. the U.K. national average of 4 days.
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Researchers found a 95% survivorship at 1 year in elderly patients who underwent primary total hip arthroplasty, according to a study presented at the EFORT Congress.
“You can do total hip replacement if the patient is fit for surgery, but the [overall] duration of stay is high, mortality is high in revision groups and patient satisfaction is good,” Jagan M.R. Velpula, DNB (Ortho), MRCS (Ed), Dip Sports Medicine, FRCS (T&O), of Good Hope Hospital in West Midlands, the United Kingdom, said.
Nonagenarian population
To discover whether total hip arthroplasty (THA) should be performed on patients older than 90 years, Velpula and senior authors Mr. S. Jain and Mr. B. Banerjee performed a retrospective study of 26 patients who underwent THA between 2003 and 2012. The patients had an average age of 93 years and average follow-up of 33.2 months. The study group included 10 men and 16 women. Velpula noted the patients were from an affluent district general hospital and were members of a high socioeconomic class or working class.
The researchers replaced both hips in this patient.
Images: Velpula JMR
Twenty-six patients underwent primary THA for osteoarthritis and six patients underwent revision THAs converted from Austin-Moore hemiarthroplasties. Surgeons used cement for all of the procedures on both the acetabular and femoral sides, Velpula said.
Results
Velpula reported no intraoperative complications. The overall average length of hospital stay was 24.72 days. The duration of stay for the primary THA patients was 21.35 days and 34.66 days for the revision patients.
“It is high in revision,” Velpula said. “[The] national average is 4 [days] in normal total hip replacement.”
The X-ray was taken postoperatively.
The researchers examined the Muller’s view of the X-ray of the cemented total hip implant.
Six patients died within 1 year following surgery. Of these six patients, five were in the revision group. Therefore, the investigators found 95% survivorship at 1 year for primary THA and 85% survivorship for the revision group.
The researchers took X-rays of the cemented total hip implant at 2-year follow-up.
The researchers took an X-ray of the cemented total hip arthroplasty at 3-year follow-up.
“[There were] good functional outcomes, improved quality of life, decreased consumption of pain killers, significant improvement in mobility and high patient satisfaction,” Velpula said. “We had to involve the multidisciplinary team and discuss with the rehab team. Preoperative counseling of the patients and family is important for the best outcome.” – by Renee Blisard Buddle
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Disclosure: Velpula has no relevant financial disclosures.