Total knee arthroplasty in patients 90 years of age and older

With increasing longevity, more patients older than age 90 now are becoming candidates for total knee arthroplasty. This article reviews our experienc e with the perioperative morbidity and early outcomes in 12 patients older than age 90, undergoing 15 total knee surgeries. Postoperative Knee Society clinical and functional scores showed excellent outcomes, and the quality of life is enhanced. There were no significant surgical complications; howe ver, there were several nonsurgical complications, including mental confusi on (3), urinary retention (3), atrial fibrillation (2), atrial flutter (1), and gallstone retention and gastrointestinal bleed (1). Most of these comp lications stemmed directly from the preoperative medical condition. These a re predictive and therefore may be recognized early and treated aggressivel y. Total knee surgery can be performed safely in patients older than 90 yea rs old with excellent pain relief and enhanced quality of life. The surgeon should be aware of the patient's past medical history because this predisp oses to postoperative morbidity.