Revision hip arthroplasty in nonagenarians


Published online: Dec 27 2010

Ian Starks, Jonathan Gregory, Stephen Phillips

From the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, U.K.

Abstract

The results of a series of revision hip arthroplasties in nonagenarians performed at a single institution over an 8 year period are presented. All data was collected prospectively. The indications for surgery, ASA grade, co-morbid medical conditions, post operative complications, blood transfusion requirements, length of in-patient stay, and discharge deposition, were recorded. Thirty day, one year and current mortality rates were calculated. Fifteen patients were identified with a mean follow-up of 3 years. There were 14 single-stage and 1 two-stage revisions. The mean age at the time of surgery was 92 years. The mean ASA grade was 2. The average inpatient stay was 14 days. Sixty three percent of patients required a period of further rehabilitation. The rate of complications was high (63%) as was the need for blood transfusion (75%). Mortality at 30 days was 7% (1/15), at 1 year 20% (3/15), and at 3 years 33% (5/15). If indicated, revision hip arthroplasty can still be considered in very elderly patients ; however, a higher than usual complication rate is to be expected.