Five-year survival of nonagenerian patients undergoing total hip replacement in the United Kingdom

Author:

Gregory J. J.1,Starks I.1,Aulakh T.1,Phillips S. J.1

Affiliation:

1. The Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire, SY10 7AG, UK.

Abstract

Between January 2000 and December 2007, 31 patients 90 years of age or older underwent total hip replacement at our hospital. Their data were collected prospectively. The rate of major medical complications was 9%. The surgical re-operation rate was 3%. The requirement for blood transfusion was 71% which was much higher than for younger patients. The 30-day, one-year and current mortality figures were 6.4% (2 of 31), 9.6% (3 of 31) and 55% (17 of 31), respectively, with a mean follow-up for the 14 surviving patients of six years. Cox’s regression analysis revealed no significant independent predictors of mortality. Only 52% of patients returned immediately to their normal abode, with 45% requiring a prolonged period of rehabilitation. This is the first series to assess survival five years after total hip replacement for patients in their 90th year and beyond. Hip replacement in the extreme elderly should not be discounted on the grounds of age alone, although the complication rate exceeds that for younger patients. It can be anticipated that almost half of the patients will survive five years after surgery.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

Reference16 articles.

1. No authors listed. Focus on older people: Office for National Statistics 2001 census. http://www.statistics.gov.uk/cci/nugget.asp?id=2157 (date last accessed 4 May 2010).

2. Smith C, Tomassini C, Smallwood S, Hawkins M. The changing age structure of the UK population. In: Chappell R, ed. Focus on people and migration. London: UK National Statistics, 2005. http://www.statistics.gov.uk/statbase/Product.asp?vlnk=12899 (date last accessed 4 May 2010).

3. No authors listed. Cohort expectations of life for males in England and Wales. Office for National Statistics, 2008. http://www.statistics.gov.uk/downloads/theme_population/NPP2008/wEWcohort08.xls (date last accessed 4 May 2010).

4. Primary and Revision Total Hip Arthroplasty for Patients 90 Years of Age and Older

5. Total joint arthroplasty in the extremely elderly

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