Total hip arthroplasty in geriatric patients – a single-center experience

Abstract

Background: As advanced age often leads to accumulating comorbidities, geriatric patients are endangered by serious events during total hip arthroplasty. This study was conducted to explore whether or not the benefit in terms of health-related quality of life (HRQoL) was comparable to younger patients. Methods: At a single academic center, 100 patients meeting the following inclusion criteria were retrospectively recruited: (1) primary arthritis of the hip leading to THA; (2) age 80 years or older at the time of surgery; (3) follow up of at least 12 months. For comparison, two further groups were recruited in the same manner, differing only in the age criterion: 100 patients aged 60–69 and 100 patients aged 70–79 at the time of hip replacement. The primary outcome was compared using the WOMAC and the EQ-5D score. The secondary outcome was determined by rates of orthopedic and non-orthopedic complications. Intragroup comparisons of the PROMS were performed by the non-parametric Wilcoxon test for paired samples. For intergroup comparisons of the PROMS, the Kruskal–Wallis-test was performed. Concerning categorial data, intergroup comparisons were performed by the Chi-Square test. The level of significance was set at 0.05. Results: Concerning the WOMAC score, neither the absolute values at 12 months after THA (p = 0.176) nor the amount of change relative to the values before surgery (p = 0.308) differed significantly between the 3 groups. Concerning the EQ-5D index the absolute values at 12 months after THA differed significantly (p = 0.008). Rates of orthopedic complications did not differ significantly (p = 0.631). Rates of non-orthopedic complications increased significantly with rising age (p = 0.033). Conclusions: Compared to younger patients, geriatric patients after THA have an equal improvement in hip-specific and general HRQoL. While rates of orthopedic complications are comparable too, non-orthopedic complications occur more frequently.

Impressive Short-Term Improvement in Functional Outcome and Quality of Life after Primary Total Hip Arthroplasty (THA) in the Orthogeriatric Patient in a Prospective Monocentric Trial

“…In this context, researchers proved an association between the preoperative prognostic nutritional index and postoperative delirium, as well as postoperative mortality [35,36] In contrast, the current literature on elective orthopedic surgery in geriatric patients is scarce. In a retrospective study design, Anderson et al compared the functional outcome (WOMAC index) and the health-related quality of life (EQ-5D-5L) between three age subgroups of patients, being 60 to 69, 70 to 79, and above 80 years old, respectively [9]. They showed comparable improvements in both scores in all three subgroups, stating that geriatric patients equally improve in comparison to younger patients.…”

“…However, the geriatric patient strongly differs from the average orthopedic one. This particular patient population often faces multimorbidity, polypharmacy, malnutrition, immobility, osteoporosis, dementia, and other geriatric syndromes [9,10]. The geriatric patient is reported to have increased complications and mortality rates after TJA [11].…”

Accuracy of Positioning and Risk Factors for Malpositioning Custom-Made Femoral Stems in Total Hip Arthroplasty—A Retrospective Multicenter Analysis

“…In light of the tremendous achievements made in this field during the 20th century, total hip arthroplasty was considered the “operation of the century” [ 1 ]. Today, total hip arthroplasty is one of the most frequently performed orthopedic operations worldwide, supported by strong evidence of the good results in terms of gain of quality of life and longevity of the implants, even in geriatric patients [ 2 ].…”