title: Total Joint Arthroplasty in Nonagenarians: What Are the Risks?
abstract: With recent increases in life expectancy in the United States, the number of nonagenarians (age 90-99 years) presenting for lower extremity joint arthroplasty (TJA) will likely rise. Utilizing the National Surgical Quality Improvement Program database, we compared 30-day outcomes of TJA between nonagenarians and controls (age <90 years). Nonagenarians had lower mean BMI, no difference in mean number of comorbidities, and shorter mean operation time. Compared to controls, nonagenarians had longer mean length-of-stay, higher readmission rate, and higher risk of postoperative adverse events. Given these findings, orthopaedic surgeons should be aware of the increased risks of TJA in nonagenarians, and should discuss these risks with potential surgical candidates during a shared decision-making process.
authors.affiliation: Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Jauregui
authors.affiliation: Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York; Department of Epidemiology and Biostatistics, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Boylan
authors.affiliation: Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Qais
authors.initials: Q
authors.lastname: Naziri
authors.affiliation: Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Maheshwari
authors.affiliation: Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011184:Postoperative Period; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States
keywords: complications; elderly; nonagenarian; outcomes; total joint arthroplasty