Very elderly can do well after joint replacements

By Michelle RizzoFri Sep 14, 6:17 PM ET
Although hip and knee replacements are rarely performed in centenarians, such very elderly patients should not be denied the option of this surgery, according to a new report.
Dr. Eswar Krishnan, of the University of Pittsburgh, Pennsylvania, and colleagues examined statistics on joint replacement procedures among centenarians and nonagenarians, using data from the Health-care Cost and Utilization Project Nationwide Inpatient Sample for the years 1993 through 2002.
A total of 679 hip replacements were identified among centenarians, compared with 33,975 among nonagenarians, the investigators report in the medical journal Arthritis and Rheumatism. There were only 7 knee replacements among centenarians, and 2,050 among nonagenarians.
Eighty-three percent of centenarians who underwent joint replacements were women.
The in-hospital mortality rate for centenarians undergoing hip replacement was 6.6 percent, compared with 4.7 percent for nonagenarians.
"The patients who get joint replacement do well in the short term," Krishnan said in an interview with Reuters Health. "They die less frequently in the post-operative period than comparable patients admitted to the hospital for other reasons," he said. "The reason for this good prognosis is that the patients are highly selected for joint replacements."
The findings suggest that joint replacements should not be denied to centenarians because of their relatively short remaining life expectancy, the researchers conclude.
Krishnan pointed out that joint replacements can improve the functional status of many elderly patients, and that "joint replacements for centenarians are likely to be more frequent in the future."
SOURCE: Arthritis and Rheumatism, August 2007.