Total Joint Arthroplasty in Nonagenarians: What Are the Risks?

With recent increases in life expectancy in the United States, the number of nonagenarians (age 90-99 years) presenting for lower extremity joint arthroplasty (TJA) will likely rise. Utilizing the National Surgical Quality Improvement Program database, we compared 30-day outcomes of TJA between nonagenarians and controls (age <90 years). Nonagenarians had lower mean BMI, no difference in mean number of comorbidities, and shorter mean operation time. Compared to controls, nonagenarians had longer mean length-of-stay, higher readmission rate, and higher risk of postoperative adverse events. Given these findings, orthopaedic surgeons should be aware of the increased risks of TJA in nonagenarians, and should discuss these risks with potential surgical candidates during a shared decision-making process.