PURPOSE: It is often a difficult decision whether it is safe to perform revision hip surgery in a patient of 80 years and older. Therefore we evaluated the results of cemented revisions in these elderly patients. METHODS: Clinical data, radiographs and complications of 49 consecutive cup and/or stem revisions in 48 patients were prospectively collected. The average age of the patients at surgery was 84 years (range, 80-92). We performed Kaplan-Meier (KM) analysis and also a competing risk (CR) analysis because in this series the presence of a competing event (i.e. death) prevents the occurrence of endpoint rerevision. RESULTS: Twenty-nine patients (30 hips) died without rerevision during follow-up and their data was included. The average follow-up of the 16 surviving patients was eight years (range, six to 13). Six re-operations were performed, of which three were re-revisions. Eight-year survivorship was 91.6% (95% confidence interval (CI) 76-97%) for endpoint re-revision for any reason. With the CR analysis we calculated that due to the increasing number of competing events, the KM analysis overestimates the failure rate with 32% for this endpoint. The average Harris hip score improved from 49 to 74. Mortality within three months after surgery was 6%. One postoperative fracture occurred and six hips dislocated. CONCLUSION: Cemented revisions can provide satisfying results in patient of 80 years and older with acceptable survivorship and complication rates.
PURPOSE: It is often a difficult decision whether it is safe to perform revision hip surgery in a patient of 80 years and older. Therefore we evaluated the results of cemented revisions in these elderly patients. METHODS: Clinical data, radiographs and complications of 49 consecutive cup and/or stem revisions in 48 patients were prospectively collected. The average age of the patients at surgery was 84 years (range, 80-92). We performed Kaplan-Meier (KM) analysis and also a competing risk (CR) analysis because in this series the presence of a competing event (i.e. death) prevents the occurrence of endpoint rerevision. RESULTS: Twenty-nine patients (30 hips) died without rerevision during follow-up and their data was included. The average follow-up of the 16 surviving patients was eight years (range, six to 13). Six re-operations were performed, of which three were re-revisions. Eight-year survivorship was 91.6% (95% confidence interval (CI) 76-97%) for endpoint re-revision for any reason. With the CR analysis we calculated that due to the increasing number of competing events, the KM analysis overestimates the failure rate with 32% for this endpoint. The average Harris hip score improved from 49 to 74. Mortality within three months after surgery was 6%. One postoperative fracture occurred and six hips dislocated. CONCLUSION: Cemented revisions can provide satisfying results in patient of 80 years and older with acceptable survivorship and complication rates.
Authors: Klaas-Auke Nouta; Bart G Pijls; Marta Fiocco; J Christiaan Keurentjes; Rob G H H Nelissen Journal: Int Orthop Date: 2013-12-05 Impact factor: 3.075
Authors: B Willem Schreurs; J J Chris Arts; Nico Verdonschot; Pieter Buma; Tom J J H Slooff; Jean W M Gardeniers Journal: J Bone Joint Surg Am Date: 2006-09 Impact factor: 5.284
Authors: J A D'Antonio; W N Capello; L S Borden; W L Bargar; B F Bierbaum; W G Boettcher; M E Steinberg; S D Stulberg; J H Wedge Journal: Clin Orthop Relat Res Date: 1989-06 Impact factor: 4.176
Authors: Roy B G Brokelman; Daniel Haverkamp; Corné van Loon; Annemiek Hol; Albert van Kampen; Rene Veth Journal: Eur Orthop Traumatol Date: 2012-04-12
Authors: Stefan Kinkel; Jan Nadorf; Marc N Thomsen; Christian Heisel; Alexander Jahnke; Jan P Kretzer; Eike Jakubowitz Journal: Int Orthop Date: 2015-07-09 Impact factor: 3.075