Editorial Comment

Biau, David; Mullins, M; Judet, T.; Piriou, P

doi:10.1097/01.blo.0000194682.33000.f9

Cited by 10 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A symmetrical distribution on funnel plot suggested no publication bias. There was a statistically significant increase in mortality among the geriatric population in 7 of the 12 studies [ 19 , 20 , 22 , 23 , 25 – 27 ], and a non-significant trend towards increased mortality in 4 of the remaining 5 [ 16 , 17 , 21 , 24 ]. One outlying study showed a non-significant trend towards decreased mortality in the geriatric population [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies [ 17 , 21 , 23 , 24 , 28 – 32 ] reported deep vein thrombosis (DVT) as a complication after total knee arthroplasty (Fig. 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Post-operative functional outcomes were compared in eleven studies [ 16 , 17 , 21 , 23 , 24 , 27 – 29 , 35 – 37 ] and is summarized in Table 2 . There was variation in follow-up period and the methodology used to assess improvement.…”

Section: Resultsmentioning

confidence: 99%

“…There was variation in follow-up period and the methodology used to assess improvement. These included subjective, self-reported scales such as the Oxford Knee Score [ 24 , 28 , 37 ], and EQ-5D [ 38 ] as well as instruments containing objectively measured data such as the Knee Score [ 17 , 23 , 35 ]. Due to the variation in the measurement scales it was not feasible to statistically combine these results.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

et al. 2016

View full text Add to dashboard Cite

BackgroundTotal knee arthroplasty is an effective treatment when nonsurgical treatments fail, but it is associated with risk of complications which may be increased in advanced age. The purpose of this study was to quantify age-related differences in perioperative morbidity and mortality after total knee arthroplasty through systematic review of existing literature.MethodsPubMed, the Cochrane database of systematic reviews, Scopus, and clinicaltrials.gov, were queried for relevant studies that compared primary total knee arthroplasty outcomes of mortality, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE) and functional status, of geriatric patients (>75 years old) with a younger control group (<65 years old). Pertinent journals and reference lists were hand searched. Eligibility criteria included all articles except case reports, meta-analyses, and systematic reviews. Two authors independently extracted data from each paper. Article quality was assessed using the Newcastle-Ottawa Scale.ResultsTwenty-two studies were included. Geriatric patients had higher rates of mortality, MI, DVT, and length of stay in older compared to younger patients, however the absolute magnitude of these increases were small. The increase in mortality may have reflected decreased life expectancy in the geriatric populations as opposed to mortality specifically due perioperative risk. There were no differences in PE incidence and improvement in pain and functional status was equal in older and younger patients. Existing studies were limited by non-randomized patient selection, as well as variation in definitions and methodology.ConclusionsExisting data supports offering primary total knee arthroplasty to select geriatric patients, although the risk of complications may be increased. Much of the data was of poor quality. Future prospective studies are needed to better identify risks and benefits of total knee arthroplasty so that patients and surgeons can make informed decisions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0215-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Nine studies [ 17 , 21 , 23 , 24 , 28 – 32 ] reported deep vein thrombosis (DVT) as a complication after total knee arthroplasty (Fig. 4 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In contrast, Biau et al found no difference in cardiac, genitourinary, neuropsychiatric, thromboembolism, or decubitus ulcer in patients older than 85 years old and those less than 75 years old. 28 …”

Section: Discussionmentioning

confidence: 99%

The Effect of Advancing Age on Total Joint Replacement Outcomes

Fang

Noiseux

Linson

et al. 2015

Geriatr Orthop Surg Rehabil

123

View full text Add to dashboard Cite

Objective:To describe age-related differences in outcomes among older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).Design:Retrospective study.Participants:A total of 1792 patients who underwent primary THA or TKA at the University of Iowa Hospitals and Clinics between 2010 and 2013 were identified in the University HealthSystem Consortium Database and University of Iowa Orthopedics Joint Replacement Registry.Main Outcome Measures:Hospital length of stay (LOS), 30-day readmission rate, in-hospital mortality, number of days admitted to intensive care unit (ICU discharge disposition), in-hospital complications (pulmonary embolism, deep vein thrombosis, wound infection, hemorrhage, sepsis, or myocardial infarction), quality of life (measured using Short-Form 36 [SF-36]), discharge disposition (home, home with home health, nursing home, inpatient rehabilitation, transfer to another acute care hospital, and dead), and total patient level observed hospital cost (based on hospital charge information from each revenue code and estimated labor costs). Outcomes were compared in patients stratified by age and categorized by decade (ie, ≤50, 51-60, 61-70, 71-80, and ≥81).Results:A total of 871 THAs and 921 TKAs were performed. The mean age of our cohort was 60.5 years and 56.1% were women. In-hospital complication rates and ICU utilization progressively increased with increasing age. There was also a higher likelihood of skilled nursing facility placement and longer LOS. There was no increase in 30-day readmissions, mortality, or total cost. Improvements in patient reported outcomes (SF-36) scores were similar for all age-groups.Conclusions:Compared to younger patients, older THA and TKA recipients were more likely to experience postoperative complications, admission to the ICU, discharge to a skilled care facility, and had longer hospital LOS. Improvements in patient-related outcomes were similar across all age-groups. These findings may be helpful when counseling older patients regarding elective total joint arthroplasty.

show abstract

The mortality, morbidity and cost benefits of elective total knee arthroplasty in the nonagenarian population

Karuppiah

Banaszkiewicz

Ledingham

2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

With the increasing life expectancy, a greater number of elderly patients are being referred to an orthopaedic department to have elective total knee arthroplasty (TKA). Total knee arthroplasty should be considered in the very elderly only after carefully balancing the benefits of surgery against the risks of surgery. The aim of this study was to analyse the mortality, morbidity and cost benefits of elective TKA in a cohort group of the nonagenarian population. Between 1990 and 2006, 42 patients ≥90 years of age had TKA surgery. Patient's notes were retrospectively analysed. A cost-benefit analysis was carried out by comparing the surgical costs against nursing home placement. The mean age at surgery was 90.4 years (range: 90-90.6). There was one major and 11 minor postoperative complications with no immediate or late postoperative deaths. The Knee Society Scores improved from 25 points (range: 8-44) to 81 points (range: 60-95), and the WOMAC Scores improved from 62 points (range: 54-73) to 41 points (range: 34-46) (p < 0.002). The calculated cost-benefit savings for 42 patients at 5 years after TKA was estimated to be £2,746,839. Total knee arthroplasty in the nonagenarian population is safe, beneficial and cost-effective.Résumé L'augmentation de la durée de vie fait qu'une population de plus en plus âgée présente les conditions pour bénéficier d'une prothèse totale du genou. La prothèse totale du genou doit être considérée dans cette population en comparant les bénéfices de la chirurgie et les risques de celle-ci. Le but de cette étude est d'analyser la mortalité, la morbidité, le rapport coût/bénéfice après prothèse totale du genou dans une cohorte de patients nonagénaires. Le rapport coût/bénéfice de ces 42 patients à 5 ans de l'utilisation de la prothèse a été estimé à 2.746.839£. La prothèse totale du genou dans une population de nonagénaire est une intervention sûre et qui permet un rapport coût/ bénéfice positif pour la société.

show abstract

Editorial Comment

Abstract: Therapeutic study, Level III (Case control study). See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 10 publications

References 0 publications

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review

The Effect of Advancing Age on Total Joint Replacement Outcomes

The mortality, morbidity and cost benefits of elective total knee arthroplasty in the nonagenarian population

Contact Info

Product

Resources

About