Giuseppe Toro1, Hugo Bothorel2, Mo Saffarini3, Laurent Jacquot1,4, Julien Chouteau1,4, Jean-Charles Rollier1,4. 1. Department of Orthopaedic Surgery, Clinique d'Argonay, Centre le Périclès, Annecy, France. 2. ReSurg SA, ch. de la Vuarpilliere 35, 1260, Nyon, Switzerland. 3. ReSurg SA, ch. de la Vuarpilliere 35, 1260, Nyon, Switzerland. journals@resurg.eu. 4. Artro Institute, Annecy le Vieux, France.
Abstract
PURPOSE: While uncemented THA has proven benefits over cemented THA, the use of uncemented components in the elderly remains controversial. The purpose of this study was to compare functional outcomes and complication rates of uncemented THA in patients aged > 80 to patients aged < 80, and determine factors that independently influence functional outcomes. METHODS: The authors evaluated 411 consecutive uncemented THAs at a follow-up of 3.1 ± 0.9 years (range 1.8-5.2), using the Oxford hip score (OHS), EuroQol 5 Dimensions (EQ-5D) score, and noting any complications. The series was divided into two age groups: elderly group (> 80, n = 142) and control group (< 80, n = 269). Uni- and multi-variable regressions were performed to test associations between outcomes and patient age, BMI, American Society of Anaesthesiologists (ASA) score, canal bone ratio (CBR) and canal flare index (CFI). RESULTS: The elderly group had femora with higher CBR (p < 0.001) and lower CFI (p = 0.002). The clinical scores were significantly worse for the elderly group, with a higher OHS (p = 0.039) and a lower EQ-5D score (p = 0.009), but there were no significant differences in overall complications rates (p = 0.500). Periprosthetic fractures were observed in three elderly patients (2.1%), compared to none of the younger patients (p = 0.041). Multi-variable regressions revealed that OHS was not correlated with any of the variables, while EQ-5D score was significantly associated with BMI (p = 0.015), ASA score (p = 0.024) and CBR (p = 0.019). CONCLUSION: Clinical outcomes of uncemented THA do not depend on patient age per se, but on more specific preoperative characteristics such as ASA score, BMI and bone quality/morphology.
PURPOSE: While uncemented THA has proven benefits over cemented THA, the use of uncemented components in the elderly remains controversial. The purpose of this study was to compare functional outcomes and complication rates of uncemented THA in patients aged > 80 to patients aged < 80, and determine factors that independently influence functional outcomes. METHODS: The authors evaluated 411 consecutive uncemented THAs at a follow-up of 3.1 ± 0.9 years (range 1.8-5.2), using the Oxford hip score (OHS), EuroQol 5 Dimensions (EQ-5D) score, and noting any complications. The series was divided into two age groups: elderly group (> 80, n = 142) and control group (< 80, n = 269). Uni- and multi-variable regressions were performed to test associations between outcomes and patient age, BMI, American Society of Anaesthesiologists (ASA) score, canal bone ratio (CBR) and canal flare index (CFI). RESULTS: The elderly group had femora with higher CBR (p < 0.001) and lower CFI (p = 0.002). The clinical scores were significantly worse for the elderly group, with a higher OHS (p = 0.039) and a lower EQ-5D score (p = 0.009), but there were no significant differences in overall complications rates (p = 0.500). Periprosthetic fractures were observed in three elderly patients (2.1%), compared to none of the younger patients (p = 0.041). Multi-variable regressions revealed that OHS was not correlated with any of the variables, while EQ-5D score was significantly associated with BMI (p = 0.015), ASA score (p = 0.024) and CBR (p = 0.019). CONCLUSION: Clinical outcomes of uncemented THA do not depend on patient age per se, but on more specific preoperative characteristics such as ASA score, BMI and bone quality/morphology.
Entities:
Keywords:
Bone morphology; Bone quality; Elderly; Periprosthetic fractures; Total hip arthroplasty; Uncemented components
Authors: Gopalakrishnan Netuveli; Richard D Wiggins; Zoe Hildon; Scott M Montgomery; David Blane Journal: J Epidemiol Community Health Date: 2006-04 Impact factor: 3.710
Authors: Daisuke Ogino; Hiroyuki Kawaji; Liisa Konttinen; Matti Lehto; Pekka Rantanen; Antti Malmivaara; Yrjö T Konttinen; Jari Salo Journal: J Bone Joint Surg Am Date: 2008-09 Impact factor: 5.284