title: The outcome of primary total hip and knee arthroplasty in patients aged 80 years or more.
abstract: Primary arthroplasty may be denied to very elderly patients based upon the perceived outcome and risks associated with surgery. This prospective study compared the outcome, complications, and mortality of total hip (TKR) and total knee replacement (TKR) in a prospectively selected group of patients aged ≥ 80 years with that of a control group aged between 65 and 74 years. There were 171 and 495 THRs and 185 and 492 TKRs performed in the older and control groups, respectively. No significant difference was observed in the mean improvement of Oxford hip and knee scores between the groups at 12 months (0.98, (95% confidence interval (CI) -0.66 to 2.95), p = 0.34 and 1.15 (95% CI -0.65 to 2.94), p = 0.16, respectively). The control group had a significantly (p = 0.02 and p = 0.04, respectively) greater improvement in the physical well being component of their SF-12 score, but the older group was more satisfied with their THR (p = 0.047). The older group had a longer hospital stay for both THR (5.9 versus 9.0 days, p < 0.0001) and TKR (6.2 versus 8.3 days, p < 0.0001). The rates of post-operative complications and mortality were increased in the older group.
authors.affiliation: The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK. nickclement@doctors.org.uk
authors.forename: N D
authors.initials: ND
authors.lastname: Clement
authors.forename: D
authors.initials: D
authors.lastname: MacDonald
authors.forename: C R
authors.initials: CR
authors.lastname: Howie
authors.forename: L C
authors.initials: LC
authors.lastname: Biant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D015207:Osteoarthritis, Hip / Q000401:mortality / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000401:mortality / Q000601:surgery; D010146:Pain / Q000534:rehabilitation; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome