OUTCOME OF HIP AND KNEE ARTHROPLASTY IN PERSONS AGED 80 YEARS AND OLDER

Recent studies have established the cost effectiveness and safety of t otal joint arthroplasties. As the population ages, it is important to determine whether these procedures are equally beneficial in the elder ly. The short term safety and efficacy of total hip and knee arthropla sties in subjects 80 years of age and older was evaluated. Between 198 8 and 1993, preoperative and postoperative physical and functional inf ormation was collected on 99 consecutive elective hip and knee arthrop lasties in subjects 80 years of age or older. These data were compared with those derived from a younger otherwise matched control group. Da ta collected included subject demographics and characteristics, inform ation concerning the acute and postacute hospital stay, comorbid condi tions, postoperative complications, discharge disposition, Hospital fo r Special Surgery knee and Harris hip scores, pain scores, and functio nal capacity. The average age of the subjects was 83 years; osteoarthr itis was the most common diagnosis; and the average followup was 25 mo nths. Complication rates and length of stay in acute care facilities w ere not significantly different than for the control group. Mean preop erative Hospital for Special Surgery knee and Harris hip scores were 5 8 and 60, respectively, with postoperative scores of 77 and 88, respec tively. Pain dramatically improved with 98% of total knee arthroplasty and 100% of total hip arthroplasty subjects reporting mild or no pain at followup. Preoperatively, none of the knee or hip subjects could w alk unlimited distances. Postoperatively 51% of the total knee arthrop lasty and 54% of the total hip arthroplasty subjects could walk more t han five blocks; 71% of the total knee arthroplasty and 86% of the tot al hip arthroplasty subjects walked with a cane or no assistive device , The most dramatic postoperative functional gains were seen in the mo st disabled subjects. Total charges of care for patients 80 years of a ge and older was slightly greater than for a younger group. It was est ablished that total joint arthroplasty can be performed safely in pati ents 80 years of age and older, promising excellent pain relief and im proved functional outcome.