TUESDAY, March 11, 2014 (HealthDay News) -- As the population
ages, more and more older people might need to have their hip
joints replaced. But how old is too old to undergo the surgery?
According to a new study, patients in their 90s who need total
hip replacement can have results comparable to younger
"Our data show that [older] patients have the ability to do better than we expected," said lead researcher Dr. Alexander Miric, an orthopedic surgeon at Kaiser Permanente, in Los Angeles.
Over a 10-year period, Miric and his colleagues compared the
results of hip replacement surgery in 183 patients who were aged 90
and above to the results of more than 43,000 other total hip
replacement surgeries performed on younger patients.
"Being in your 90s need not disqualify you from having a hip replacement surgery," Miric said.
He is scheduled to present the findings Tuesday at the annual
meeting of the American Academy of Orthopaedic Surgeons, in New
Hip replacement surgery, often needed because of the
wear-and-tear arthritis known as osteoarthritis, has been done
since 1960, according to the academy, but techniques have improved.
About 285,000 total hip replacement procedures are done annually in
the United States, according to the U.S. Agency for Healthcare
Research and Quality.
Miric's team looked at data collected by a total joint
replacement registry. They analyzed hip replacement surgeries done
from April 2001 through December 2011.
The researchers compared three age groups: younger than 80, 80
to 89 and 90 and older. They compared the lengths of the hospital
stay, complications after surgery, death rates and readmissions to
the hospital up to 90 days after the surgery.
Although none of the patients 90 and older had serious blood
clots known as deep vein thrombosis, 1.2 percent of the those aged
80 to 89 did. Meanwhile, less than 1 percent of the younger
"Compared to those under 80, they did not have higher rates of infection," Miric said of the patients over 90.
The oldest patients did stay in the hospital a bit longer: 3.4
days on average, compared to 2.8 days for the youngest patients and
3.3 days for the 80- to 89-year-olds.
The oldest patients also were more likely to be readmitted
within the three months after the surgery.
And the oldest had the highest death rates within the 90-day
follow-up period -- 2.7 percent compared with 1.3 percent for
patients aged 80 to 89 and 0.2 percent for those under 80.
Miric said the bottom line for nonagenarians with worn-out hips
is optimistic: "If you are in your 90s, it is reasonable to have
that conversation [about surgery] with your surgeon."
The study results are not surprising, said Dr. Craig Della
Valle, a professor of orthopedic surgery at Rush University Medical
Center in Chicago. He reviewed the findings but was not involved in
He, too, has performed total hip replacement surgery on
90-year-olds with good results, he said. "Most folks who live to 90
years old and have symptomatic arthritis are generally a pretty
hardy crowd," he said. "If they are healthy enough that their
arthritis bothers them, it usually means they are active and can
tolerate elective surgery."
He cautioned, however, that patients of this age, as well as
other ages, need a thorough preoperative evaluation to be sure they
are good candidates for the procedure.
However, he said, the death rate of 2.7 percent found in the
study for those 90 and above seems high.
In response, Miric said the one-year death rate of people 90 and
above, in general, is about 20 percent. In his study, however, the
one-year death rate of the 90-and-up group was 5.5 percent.
Because this study was presented at a medical meeting, the data
and conclusions should be viewed as preliminary until published in
a peer-reviewed journal.
To learn more about hip replacement surgery, visit the
American Academy of Orthopaedic Surgeons.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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