Outcome and Long-Term Results Following Total Hip Replacement in Elderly Patients

Lévy, Roger; Levy, C. M.; Snyder, Judith A.; Digiovanni, Joseph

doi:10.1097/00003086-199507000-00005

Cited by 71 publications

(36 citation statements)

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“…The rate of mild post-operative confusion was similar in both groups: 3.8% in cemented group versus 5.7% in noncemented group (Table 2). This rate is lower than the other reports in the literature ranging 6% to 17.6% [26,[31][32][33][34].…”

Section: Discussioncontrasting

confidence: 70%

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Meftah

John

Lendhey

et al. 2013

The Journal of Arthroplasty

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Section: Discussioncontrasting

confidence: 70%

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Meftah

John

Lendhey

et al. 2013

The Journal of Arthroplasty

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“…Levy et al [9] showed that 88% of patients older than 80 years of age after primary THA were community ambulators at long-term followup. The Charnley hip scoring system, Harris hip scores, Merle d'Aubigne system, and WOMAC scores have consistently shown improved results after primary THA in older patients when compared with arthritic younger patients undergoing the same procedure [6,7,9,10,15,17,19]. However, concerns about the safety and increased complications remain in the elderly undergoing primary THA; this is especially important in the bundled payment era in which institutions and providers are financially responsible for complications and readmissions.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have found the incidence of dislocation after primary THA to range from 4% to 15% [9,13]. With the advent of larger femoral head sizes, capsular repair, and newer approaches, dislocation rates have decreased [4,18].…”

Section: Discussionmentioning

confidence: 99%

High Risk of Readmission in Octogenarians Undergoing Primary Hip Arthroplasty

Malkani

Dilworth

Ong

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background As life expectancy increases, more elderly patients with end-stage hip arthritis are electing to undergo primary THA. Octogenarians undergoing THA have more comorbidities than younger patients, but this is not reflected in risk adjustment models for bundled care programs. The burden of care associated with THA in octogenarians has not been well characterized, and doing so may help these value-based programs make adjustments so that this vulnerable patient population does not risk losing access under accountable care models.Questions/purposes The purpose of this study was to describe care use, comorbidities, and complications among octogenarians undergoing primary THA. Methods Five percent of the Medicare national administrative claims data was queried to identify patients diagnosed with hip osteoarthritis between January 1, 1998, and December 31, 2013. Patients who underwent primary THA were identified and followed longitudinally during the study period using their unique, encrypted Medicare beneficiary identifiers. We compared risk factors and complications between the octogenarian group versus those aged 65 to 69 years. Multivariate Cox regression was used to evaluate the effect of patient/hospital factors on risk of revision, periprosthetic joint infection, dislocation, venous thromboembolism (VTE), and mortality. Patient factors in the model included age, sex, race, region, socioeconomic status, and health status based on Charlson comorbidity score 12 months before replacement surgery. Results There were 11,960 THAs in the octogenarians in 1998, which increased to 21,620 in 2013, an 81% increase during this study period. Octogenarians were more likely to have a Charlson score of 3 or higher than those patients aged 65 to 69 years (30% versus 17%, odds ratio [OR] 2.07 [1.98-2.20]; p \ 0.001), and they were more likely to have coronary artery disease or congestive heart failure (47% versus 29%, OR 2.16 [2.06-2.26]; p \ 0.001). The octogenarian group had a greater risk of dislocation (+12%, p = 0.01), VTE (+14%, p\0.001), and mortality (+150%, p\ 0.001) compared with the younger age cohort. A total of 21% of the octogenarians were readmitted after surgery compared with 12% for patients in the younger group (OR=1.64, 95% confidence interval 1.54-1.75; p \ 0.001). Conclusions Because octogenarians are at increased risk of dislocation, VTE, medical complications, and mortality after THA, value-based care models that penalize hospitals One or more of the authors (KO, DB, EL) are employees of Exponent, Inc. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research1 editors and board members are on file with the publication and can be viewed on request. This work was performed at

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“…36 Despite the overall success of hip replacement, studies have documented that 5% to 25% of patients who undergo this procedure report minimal improvement or dissatisfaction with their outcomes. 14,[16][17][18][37][38][39][40][41][42][43] In hip resurfacing, the femoral head is left in place but trimmed and capped with a metal covering. The damaged acetabulum cartilage is removed and replaced with a metal shell, similar to a traditional hip replacement.…”

Section: Obesitymentioning

confidence: 99%

Surgical management of hip osteoarthritis

Gandhi

Perruccio

Mahomed

2013

CMAJ

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Review CMAJ• Total hip replacement with a metal-on-polyethylene bearing surface remains the gold standard for the treatment of end-stage hip osteoarthritis, providing reliable improvement in pain and function with consistent implant longevity.• Registry reports suggest an increased rate of revision for hip resurfacing compared with total hip replacement, particularly among female patients.• A further registry report showed an increased failure rate of metal-onmetal bearing surfaces compared with ceramic and polyethylene at 7 years.• The outcomes of revision total hip replacement are poorer than those of primary replacement, with patients reporting worse pain and poorer function at 5 years after revision surgery.

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Outcome and Long-Term Results Following Total Hip Replacement in Elderly Patients

Cited by 71 publications

References 0 publications

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

High Risk of Readmission in Octogenarians Undergoing Primary Hip Arthroplasty

Surgical management of hip osteoarthritis

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