Octogenarians have low risk for TKA complications
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CHICAGO — Results of a database study presented here showed there should be minimal concern regarding medical and implant-related complications due to age in patients older than 80 years who undergo total knee arthroplasty.
However, according to findings from Martin W. Roche, MD, FAAOS, of Hospital for Special Surgery in West Palm Beach, Florida, and colleagues who studied the procedure among octogenarians, patients and their physicians should be aware these patients have a risk for higher readmission rates, certain medical complications and postoperative length of stay after TKA compared with younger patients.
Roche and colleagues used a database to identify octogenarians who underwent TKA and a group of similar patients aged 65 to 69 years who served as the control cohort. Their analysis involved more than 1.7 million patients.
Per the abstract, octogenarians had an equal incidence and odds of developing any medical complication as the controls, although some medical complications were noted among the octogenarian patients. These complications included a significantly higher incidence and odds of 90-day readmission, which was 10.59% vs. 9.35% in the controls.
In addition, data showed a significantly longer in-hospital length of stay in octogenarian patients compared with the controls.
“I think the odds ratio being so close was interesting to me because, if you look at this database that we selected, it goes back to 2005. We, back then doing joints, were keeping patients in the hospital longer so that they could go to [skilled nursing in-patient facilities] and rehab. So length of stay, I think, is kind of probably social more and economic driven than need,” Roche told Healio.
He said patients and their families still need to be cognizant of the overall health of an octogenarian patient who plans to undergo TKA.
“This is a nice paper,” Roche said, noting he can tell family members who care for or who are interested in the care of an older relative “we have data now that show octogenarians do as well, in certain cases better, in terms of thrombophlebitis than our younger cohort of patients.”
He told Healio, “So as long as their medical comorbidities, such as diabetes and things are well maintained, their risks are almost equal. Their family should have security that their loved ones should get through the brief recovery process and have a good functional outcome.”
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Wakefield C, et al. Poster 0120. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 22-26, 2022; Chicago.
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