Cemented total hip arthroplasty revisions in patients of eighty years and older

• Published in: International orthopaedics Vol. 39; no. 9; pp. 1723 - 1730
• Main Authors: te Stroet, Martijn A. J., Ghisai, Sushma A., Keurentjes, J. Christiaan, Rijnen, Wim H. C., Gardeniers, Jean W. M., Van Kampen, Albert, Schreurs, B. Willem
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2015
• Subjects: Age Factors; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; Bone Cements; Cementation; Female; Follow-Up Studies; Hip Dislocation - etiology; Hip Dislocation - surgery; Humans; Male; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Prosthesis Failure; Reoperation; Risk Assessment; Clinical outcome; Kaplan-Meier survival analysis; Radiographic analysis; Complications; Revision total hip arthroplasty; Cemented; Elderly; 80 years and older
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-015-2722-x

Purpose It is often a difficult decision whether it is safe to perform revision hip surgery in a patient of 80 years and older. Therefore we evaluated the results of cemented revisions in these elderly patients. Methods Clinical data, radiographs and complications of 49 consecutive cup and/or stem revisions in 48 patients were prospectively collected. The average age of the patients at surgery was 84 years (range, 80–92). We performed Kaplan-Meier (KM) analysis and also a competing risk (CR) analysis because in this series the presence of a competing event (i.e. death) prevents the occurrence of endpoint rerevision. Results Twenty-nine patients (30 hips) died without rerevision during follow-up and their data was included. The average follow-up of the 16 surviving patients was eight years (range, six to 13). Six re-operations were performed, of which three were re-revisions. Eight-year survivorship was 91.6 % (95 % confidence interval (CI) 76–97 %) for endpoint re-revision for any reason. With the CR analysis we calculated that due to the increasing number of competing events, the KM analysis overestimates the failure rate with 32 % for this endpoint. The average Harris hip score improved from 49 to 74. Mortality within three months after surgery was 6 %. One postoperative fracture occurred and six hips dislocated. Conclusion Cemented revisions can provide satisfying results in patient of 80 years and older with acceptable survivorship and complication rates.