Cementless Total Hip Arthroplasty in Octogenarians

Stihsen, Christoph; Springer, Bernhard; Nemecek, Elena; Olischar, Boris; Kaider, Alexandra; Windhager, Reinhard; Kubista, Bernd

doi:10.1016/j.arth.2017.01.029

Cited by 15 publications

(6 citation statements)

References 43 publications

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“…30 Additionally, octogenarians undergoing cementless THA were significantly more likely to develop a systemic complication (p < 0.01) compared to those under the age of 80. 31 Several findings for readmissions and mortality in octogenarians following other orthopedic procedures are contrary to ours. In patients undergoing elective TSA, octogenarians were found to have significantly higher rates of readmission (p ¼ 0.002) compared to those under the age of 70.…”

Section: Discussioncontrasting

confidence: 96%

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Thirty-day morbidity and mortality following revision total shoulder arthroplasty in octogenarians

2021

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Background Octogenarians are at an increased risk of morbidity and mortality following various surgeries, but this has not yet been well explored in octogenarians undergoing revision total shoulder arthroplasty (RTSA). Thus, the purpose of this study was to analyze whether octogenarians undergoing RTSA are at an increased risk of 30-day postoperative complications, readmissions, and mortality relative to the younger geriatric population. Methods Data of patients who underwent RTSA from 2013 to 2018 were obtained from a large de-identified database. Patients were divided into two cohorts: ages 65–79 and ages 80–89. Demographic data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate and multivariate analyses were performed. Results On bivariate analyses, patients aged 80–89 were more likely to develop pulmonary embolism (p = 0.014) and extended length of stay more than 3 days (p = 0.006) compared to the cohort aged 65–79. Following adjustment on multivariate analyses, 80–89 years old patients no longer had an increased likelihood of pulmonary embolism or extended length of stay compared to the 65–79 age group. Octogenarians were not found to have higher rates of 30-day readmissions (p = 0.782), mortality (p = 0.507), reoperation (p = 0.785), pneumonia (p = 0.417), urinary tract infection (p = 0.739), or sepsis (p = 0.464) compared to the cohort aged 65–79 following RTSA. Conclusion Age greater than 80 should not be used independently as a factor for evaluating whether a geriatric patient is a proper candidate for RTSA.

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Section: Discussioncontrasting

confidence: 96%

“…30 Additionally, octogenarians undergoing cementless THA were significantly more likely to develop a systemic complication (p < 0.01) compared to those under the age of 80. 31…”

Section: Discussionmentioning

confidence: 99%

Thirty-day morbidity and mortality following revision total shoulder arthroplasty in octogenarians

2021

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“…[1][2][3] While total hip arthroplasty (tHa) for degenerative joint disease remains among the most successful procedures of the 20th century, 4 knowledge on outcomes and characteristics in elderly patients is limited to a few studies. [5][6][7] Moreover, studies on tHas in octogenarians and older patients rarely describe complications, and almost nothing is known on periprosthetic joint infections (pJis) in this uniquely challenging cohort. 8,9 the purpose of this investigation is to explore the baseline demographic details, infection characteristics, surgical outcomes, as well as perioperative complications in octogenarians revised for pJi of a tHa in a single university-based institution.…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic hip infection in octogenarians

Karczewski

Schönnagel

Hipfl

et al. 2023

The Bone & Joint Journal

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Aims Periprosthetic joint infection (PJI) in total hip arthroplasty in the elderly may occur but has been subject to limited investigation. This study analyzed infection characteristics, surgical outcomes, and perioperative complications of octogenarians undergoing treatment for PJI in a single university-based institution. Methods We identified 33 patients who underwent treatment for PJIs of the hip between January 2010 and December 2019 using our institutional joint registry. Mean age was 82 years (80 to 90), with 19 females (57%) and a mean BMI of 26 kg/m2 (17 to 41). Mean American Society of Anesthesiologists (ASA) grade was 3 (1 to 4) and mean Charlson Comorbidity Index was 6 (4 to 10). Leading pathogens included coagulase-negative Staphylococci (45%) and Enterococcus faecalis (9%). Two-stage exchange was performed in 30 joints and permanent resection arthroplasty in three. Kaplan-Meier survivorship analyses were performed. Mean follow-up was five years (3 to 7). Results The two-year survivorship free of any recurrent PJI was 72% (95% confidence interval (CI) 56 to 89; 18 patients at risk). There were a total of nine recurrent PJIs at a mean of one year (16 days to eight years), one for the same pathogen as at index infection. One additional surgical site infection was noted at two weeks, resulting in a 69% (95% CI 52 to 86; 17 patients at risk) survivorship free of any infection at two years. There were two additional revisions for dislocations at one month each. As such, the two-year survivorship free of any revision was 61% (95% CI 42 to 80; 12 patients at risk). In addition to the aforementioned revisions, there was one additional skin grafting for a decubitus ulcer, resulting in a survivorship free of any reoperation of 54% (95% CI 35 to 73; ten patients at risk) at two years. Mean Clavien-Dindo score of perioperative complications was two out of five, with one case of perioperative death noted at six days. Conclusion Octogenarians undergoing surgery for PJI of the hip are at low risk of acute mortality, but are at moderate risk of other perioperative complications. One in two patients will undergo a reoperation within two years, with 70% attributable to recurrent infections. Cite this article: Bone Joint J 2023;105-B(2):135–139.

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“…However, prior studies have demonstrated primary THA as a viable and safe option in older patients with excellent rate of implant survival. 32,33 Third, emergency room visits and hospital readmission outside of our institutional health system may not have been captured. However, our health system is the predominant provider in the region, so chances of this occurring are relatively small.…”

Section: Discussionmentioning

confidence: 99%

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

Warren

Groover

Santana

et al. 2020

The Journal of Hip Surgery

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Total hip arthroplasty (THA) has been proven to be a safe and efficacious operation; however, there is a paucity of literature on outcomes in patients in the 99th percentile for height. The objectives of this study were to identify differences in (1) implant selection, (2) operative times, (3) intraoperative and postoperative complications, (4) 90-day readmission, (5) all cause reoperation rates, and (6) hospital length of stay (LOS), in tall-statured patients compared with a matched control cohort. An electronic research request was used to identify 12,850 patients who underwent THA from January 2012 to December 2016 with minimum 1-year follow-up at a single health care system for retrospective chart review. Patients were identified in the 99th percentile for height (193 cm for males and 177 cm for females) and then matched to controls based on gender, race, age, body mass index, and Charlson comorbidity index. A total of 260 THA patients (2%) were identified in the 99th percentile for height. The tall-statured patients were then matched to 248 patients of normal stature. The exclusion criteria was met by 172 tall-statured patients and 165 normal-statured patients. Final analysis comprised of 86 tall-statured patients (100 THA) and 83 matched normal-statured patients (92 THA). Baseline demographics information and the outcomes of interest were then compared. The mean height of the female patients in the tall cohort was 181.01 ± 2.51 cm compared with 166.6 ± 6.98 cm for the control group (p < 0.001), while it was 195.25 ± 4.03 cm for male patients in the tall cohort and 174.11 ± 4.63 cm for the control cohort (p < 0.001). Tall-statured patients had larger acetabular cups (p < 0.001) and femoral head (p = 0.046) components. There were no differences in reoperation (p = 0.282), 90-day readmissions (p = 0.862), intraoperative fractures (p = 0.228), postoperative complications (p = 0.678), operative times (p = 0.890), and LOS (p = 0.099) between the tall-statured and normal-statured patients. Patients that are in the 99th percentile for height have similar outcomes to patients that are of normal height. The level of evidence of this study is level 3.

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Cementless Total Hip Arthroplasty in Octogenarians

Cited by 15 publications

References 43 publications

Thirty-day morbidity and mortality following revision total shoulder arthroplasty in octogenarians

Thirty-day morbidity and mortality following revision total shoulder arthroplasty in octogenarians

Periprosthetic hip infection in octogenarians

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

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