Stay Hip, Even After 80

Main Category: Seniors / Aging
Also Included In: Bones / Orthopaedics;  Arthritis
Article Date: 26 Dec 2007 - 0:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

For men and women over age 80, hip replacement surgery may still be a viable option, according to a study published in the December 2007 issue of The Journal of Bone and Joint Surgery. Patients 80 and older are experiencing hip replacement outcomes comparable to those of their younger counterparts.

More than 234,000 total hip replacements (also known as hip arthroplasties) are performed in the U.S. each year; this number has increased dramatically in the last decade. Total hip replacement is a surgical procedure in which the patient's natural hip joint is replaced with an artificial one, composed of plastic and metal or ceramic. The most common reasons for this surgery are:

- Pain and stiffness in the hip which limits normal activities, such as walking and bending.
- Pain that cannot be satisfactorily treated with medication or other therapies.

These conditions are most frequently caused by:

- Osteoarthritis , which can result from aging.
- Rheumatoid arthritis, which is caused by an autoimmune disease.
- Traumatic arthritis, which can result from injury.

The study compared the outcomes of hip arthroplasty patients 80 years and above and those who were 70 years and below, six to seven years after their surgery. Results showed that patients in the 80 year old group at the time of surgery had comparable strength and function in the replaced hip(s) as did the patients who were 70 years or younger at the time of surgery.

"Many older people who could benefit from hip arthroplasty choose not to have the surgery because of their age," says Javad Parvizi, MD, FRCS, one of the study's authors. Dr. Parvizi is director of clinical research and an associate professor at the Rothman Institute at Thomas Jefferson University in Philadelphia. "They think the surgical recovery will be too difficult or that it's just not worth it at their age. There are patients who use wheelchairs because of hip pain, but are afraid to have this surgery. This study shows that people in their 80s can look forward to an excellent surgical outcome and therefore have a much improved quality of life."

The study also found that the octogenarians had a similar rate of complications as did the younger group, and no patients in either group died as a result of the surgery. Some patients in the octogenarian group did die from other causes during the follow-up period, and nearly all of them had good hip function at the time.

The most common complication following hip replacement was dislocation, but the octogenarian group had a lower rate of dislocation; researchers believe that this is most likely because surgeons used a more constraint device in the older patients. In addition, they say, it seems that the medical optimization process to prepare patients for surgery, as well as the close monitoring in the postoperative period, may have been more extensive and stringent for the older patients.

"Patients who are suffering from hip pain should be evaluated to determine whether hip replacement might be a good option for them, regardless of their age," Parvizi says. "Our results show that age alone is not a contraindication for hip replacement."

American Academy of Orthopaedic Surgeons