With increasing age, the safety and desirability of performing hip and knee replacements (arthroplasty) may be questioned with the idea that health care resources should be spent on those who can potentially benefit from them the most, and such procedures may be too hazardous for elderly patients.
However, there have been few studies on joint replacement among patients older than 90. A new study published in the August issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) found that hip and knee replacements are very infrequent among this age group, but that they should not be denied to these patients solely because of short-term life expectancy. The study was the largest to date of hip and knee replacements among centenarians.
Led by Eswar Krishnan, MD, MPH, of the University of Pittsburgh, in Pittsburgh, PA, researchers analyzed 10-year data (1993-2002) from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, the largest hospital discharge data set in the world. Of the 57 million hospitalization records during this period, 41,335 were for centenarians. The researchers identified 679 total hip replacements and 7 total knee replacements in patients aged 100 or older. “This relatively low frequency of elective surgery might be due to physician and patient judgment that these individuals are at high risk for poor outcomes and that the risk is not offset by the perceived benefit in light of the relatively short life expectancy,” the authors state. Centenarians who underwent hip replacement were at a higher risk for in-hospital mortality than nonagenarians. Among centenarians, however, hospitalization for hip replacement compared to other causes of hospitalization was associated with a lower risk of death.
Although frailty is known to increase with age, some believe that with better medical care only the extremely elderly are suffering its effects. The authors point out that centenarians live to the century mark by delaying or even avoiding many age-related diseases, and that among those suffering from such conditions, many appear to do so with better functional status than younger patients. As to the question of whether centenarians and nonagenarians are able to reap the benefits of a new hip or knee, a previous study indicated that one-quarter of the centenarian population are cognitively intact and they appear to sustain their mental status over time. Another study found that nonagenarians treated for hip fractures did not have an increased risk of postoperative complications.
Given the increasing trend of joint replacements over the last decade in the U.S. and the growing centenarian population, such procedures are likely to become more commonplace in the elderly population. The authors conclude, “This study provides data that suggest arthroplasty need not be denied to centenarians solely on account of age and the concern of high in-hospital mortality risk.”
Amy Molnar | EurekAlert!
WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf
First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...
A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.
The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...
02.05.2018 | Event News
13.04.2018 | Event News
12.04.2018 | Event News
22.05.2018 | Life Sciences
22.05.2018 | Earth Sciences
22.05.2018 | Trade Fair News