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Total Hip Arthroplasty Can Be Performed Safely in 90-Year-Olds

Comorbidities tied to higher rates of complications and postoperative morbidity

By Lori Solomon HealthDay Reporter

THURSDAY, Aug. 31, 2023 (HealthDay News) — While 90-year-olds undergoing elective total hip arthroplasty (THA) have higher complication and mortality rates than younger patients undergoing THA, their mortality rates are lower than for 90-year-olds in the general population, according to a study published online Aug. 25 in the Journal of Bone and Joint Surgery.

Vincent J. Leopold, M.D., from Charité – Universitätsmedizin Berlin, and colleagues evaluated postoperative mortality and morbidity after THA in nonagenarians as well as underlying risk factors. The analysis included data from 263,967 THAs (including 1,859 performed on nonagenarians).

The researchers found that the greatest risk factors for major and minor complications and mortality were congestive heart failure, pulmonary circulation disorders, insulin-dependent diabetes, renal failure, coagulopathy, and fluid and electrolyte disorders. The risks for major and minor complications and mortality were significantly higher in nonagenarians versus younger patients. The occurrence of major complications was associated with increased mortality. The survival rate in patients without a major complication was 94.4 percent after one year versus 79.8 percent in patients with a major complication. At 90 years of age, one-year mortality rates in the study group were 10.5 percent for men and 6.4 percent for women versus 18.5 percent for men and 14.7 percent for women in the general population.

“The fact that mortality is still lower than within the general population shows that this aspect can be controlled by careful patient selection and adequate preparation,” write the authors.

One author disclosed ties to the pharmaceutical industry.

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