Hip replacement in the very elderly: selecting a suitable candidate

Abstract

The selection of a suitable candidate for hip arthroplasty involves several important patient-specific considerations. Advanced age may be considered a relative contraindication for elective surgery, and may unfortunately cause a stereotypical dismissal of very elderly patients with a painful hip. However, several studies have demonstrated the exceptional safety and symptomatic benefits of hip arthroplasty in octogenarians and nonagenarians when appropriate medical precautions and preparations are utilized. The very elderly present specific social and medical scenarios that must be identified to establish an accurate risk assessment and achieve an optimal postoperative result. Although a greater likelihood of perioperative complications exists, the very elderly can expect to achieve highly significant pain relief and functional improvement after hip replacement. Future studies will focus on improvements in outcomes after hip replacement that may be realized with new advances in postoperative protocols.