Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Hip and knee replacements rarely performed in patients over 100

31.07.2007
According to the U.S. Department of Census, the number of centenarians could cross the 4 million mark by 2050. Although approximately 40 percent of centenarians are functionally independent, they are among those at the highest risk for disabling arthritis and fractures due to osteoporosis.

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!
Further information:
http://www.wiley.com
http://www.interscience.wiley.com/journal/arthritiscare

More articles from Studies and Analyses:

nachricht Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Color effects from transparent 3D-printed nanostructures

New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference

Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

LaserForum 2018 deals with 3D production of components

17.08.2018 | Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

 
Latest News

Smallest transistor worldwide switches current with a single atom in solid electrolyte

17.08.2018 | Physics and Astronomy

Robots as Tools and Partners in Rehabilitation

17.08.2018 | Information Technology

Climate Impact Research in Hannover: Small Plants against Large Waves

17.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>