BACKGROUND: This investigation used age as a continuous variable to estimate implant survival and the risk of complications. METHODS: Prospectively collected data were used to analyze 5494 consecutive shoulder arthroplasties performed from 1970 to 2012. Patients were a mean age of 67 years. The association between the age at the index procedure and the risk for each outcome was assessed using Cox regression and smoothing spline analysis. RESULTS: Older age was associated with a decreased risk of revision surgery, revision for mechanical failure, and reoperation but with a higher risk for thromboembolic events. Reoperation rates also decreased in a linear fashion with older ages (P < .001). The risk of revision surgery decreased in a linear fashion between the ages of 40 and 85, with a 3% decreased risk of revision per 1-year increase in age (P < .01). This association held true in a multivariate model and when specific procedures were separated out. Compared with patients aged <50 years, patients aged from 50 to 65 years (P < .001) and those >65 years (P < .001) have decreased risks of revision surgery. The risk of a revision surgery in a patient aged >50 years was significantly decreased (~13% reduction in risk for each year; P < .001). There was a subtle association between older age and decreased rates of infection (P = .01). CONCLUSIONS: There is a strong association between older age and decreased rates of revision surgery and reoperation after shoulder arthroplasty, with a striking association with decreased rates of mechanical failure. These are important considerations when counseling younger patients regarding their risks.
BACKGROUND: This investigation used age as a continuous variable to estimate implant survival and the risk of complications. METHODS: Prospectively collected data were used to analyze 5494 consecutive shoulder arthroplasties performed from 1970 to 2012. Patients were a mean age of 67 years. The association between the age at the index procedure and the risk for each outcome was assessed using Cox regression and smoothing spline analysis. RESULTS: Older age was associated with a decreased risk of revision surgery, revision for mechanical failure, and reoperation but with a higher risk for thromboembolic events. Reoperation rates also decreased in a linear fashion with older ages (P < .001). The risk of revision surgery decreased in a linear fashion between the ages of 40 and 85, with a 3% decreased risk of revision per 1-year increase in age (P < .01). This association held true in a multivariate model and when specific procedures were separated out. Compared with patients aged <50 years, patients aged from 50 to 65 years (P < .001) and those >65 years (P < .001) have decreased risks of revision surgery. The risk of a revision surgery in a patient aged >50 years was significantly decreased (~13% reduction in risk for each year; P < .001). There was a subtle association between older age and decreased rates of infection (P = .01). CONCLUSIONS: There is a strong association between older age and decreased rates of revision surgery and reoperation after shoulder arthroplasty, with a striking association with decreased rates of mechanical failure. These are important considerations when counseling younger patients regarding their risks.
Authors: Peter Lc Lapner; Meaghan D Rollins; Meltem G Tuna; Caleb Netting; Anan Bader Eddeen; Carl van Walraven Journal: J Shoulder Elb Arthroplast Date: 2019-10-21
Authors: Jacob M Wilson; Russell E Holzgrefe; Christopher A Staley; Spero Karas; Michael B Gottschalk; Eric R Wagner Journal: Shoulder Elbow Date: 2019-09-26
Authors: Sambit Sahoo; Kathleen A Derwin; Alexander Zajichek; Vahid Entezari; Peter B Imrey; Joseph P Iannotti; Eric T Ricchetti Journal: J Shoulder Elbow Surg Date: 2020-08-26 Impact factor: 3.019
Authors: Kamil M Amer; Dominick V Congiusta; Pooja Suri; Aziz M Merchant; Michael M Vosbikian; Irfan H Ahmed Journal: J Clin Orthop Trauma Date: 2020-01-23
Authors: Samuel E Broida; Aidan P Sweeney; Michael B Gottschalk; Jarret M Woodmass; Eric R Wagner Journal: Eur J Orthop Surg Traumatol Date: 2021-08-09