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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_6 | Pages 16 - 16
2 May 2024
McCann C Brunt A Walmsley P Akhtar A
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There is an increasing demand worldwide for total hip arthroplasty in patients over 80 years old. This study is the largest of its kind reporting long term outcomes and clinical survivorship of patients over 80 years old undergoing THR.

13171 patients 80 years or older who underwent THR between 2000 and 2019 were included. Demographic and operative data was collected including age, sex, laterality, date of surgery and operative technique. Presence and date of complications were collected. Data was also collected for the same time period on 80910 patients aged 51–79 years undergoing THR for comparison.

4103 (31.2%) male and 9068 female (68.8%) patients were included in the 80year old cohort. Median age was 83 (IQR 81–83, range 80–98). 32682 (40.4%) male and 48227 (59.6%) females were included in the 50–79year old cohort. Median age was 68 (IQR 62–73, range 50–79).

The 80 cohort was more likely to sustain post operative complications in the 6 months following surgery including DVT (81/13171 vs 364/80910, P<0.05), myocardial infarction (177/13171 vs 341/80910, P<0.05), acute renal failure (371/12800 vs 812/80910 P<0.05).

The 50–79year old cohort was over twice as likely to undergo revision surgery than the 80 year old cohort (HR 2.55, 95% CI 2.216–2.932, p<0.001). Of those requiring revision surgery, the elderly cohort were more likely to undergo earlier revision surgery (378days, 95%CI 236–519d vs 1586days, 95%CI 1471–1700d, p<0.001). In those undergoing revision surgery, a higher proportion were done for infection in the 80 year old cohort (39/219 (17.8%) vs 215/2809 (7.7%), p<0.05.

This study demonstrates good outcomes in terms of medical complications and a low overall risk of requiring revision surgery in patients 80years old undergoing THR. Patients over the age of 80 should be counselled on the relatively increased risk of medical complications post operatively.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 94 - 94
1 Jul 2022
Brunt A Walmsley P
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Abstract

Introduction

The number of total knee replacements (TKRs) performed continues to increase and is marked in patients under the age of 60. Increased number of younger patients raises concerns about potentially increased rates of implant failure or revision. Previous studies used small cohorts with only short to medium term follow-up. This study is the largest of its kind reporting long term outcomes and clinical survivorship of patients 50 years or less undergoing TKR.

Methods

This is a retrospective cohort study using data from the Scottish Arthroplasty Project. A total of 3727 patients 50 years or less undergoing TKR between 2000 and 2019. Data was also collected for the same time period on patients aged 50–79 years undergoing TKR for comparison.