Today's News

Friday, March 2, 2001

THR for patients over age 90 found reliable and safe

Advances in medical care have allowed more patients to live until they are in their 90s and beyond. Little data exists about the safety or efficacy of total hip arthroplasty in this very elderly population and some physicians and surgeons may be hesitant to recommend elective surgery in this group.

However, a study in scientific paper 112, presented Thursday, indicates total hip arthroplasty in this large group of patients over 90 years of age was reliable, durable and safe.

The study involves 66 hips done in 65 patients age 90 to 104 years (mean: 92 years). The diagnosis was osteoarthritis in 50 hips, posttraumatic arthritis in eight hips and a failed prior prosthesis in seven hips. The components were inserted with cement in the majority of cases. Preoperative medical conditions and postoperative complications were recorded in detail.

All patients were followed until death or for a minimum of two years (mean: 4.2 years). No revisions were required. Two reoperations were done: one debridement for infection and one hematoma evacuation. Seven additional surgical complications occurred including three femoral fractures, two hematomas, one dislocation and one pulmonary embolus.

Harris hip scores improved significantly (p< 0.0001) from 41 points preoperatively to 79 at last follow-up. Preoperative medical conditions included cardiac disease in 34 patients (52 percent), hypertension in 27 (41 percent), and anemia in 22 (33 percent). Sixteen patients required a stay (mean: 1.9 days) in the intensive care unit.

Coauthors of the study are Mark W. Pagnano, MD; Lori McLamb, PA-C; and Robert T. Trousdale, MD, all of Mayo Graduate School, Rochester, Minn.

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2001 Academy News March 2 Index B

Last modified 20/February/2001 by IS