Revision Total Knee Arthroplasty in Octogenarians: An Analysis of 957 Cases

被引:23
作者
Bovonratwet, Patawut [1 ]
Tyagi, Vineet [1 ]
Ottesen, Taylor D. [1 ]
Ondeck, Nathaniel T. [1 ]
Rubin, Lee E. [1 ]
Grauer, Jonathan N. [1 ]
机构
[1] Yale Sch Med, Dept Orthopaed & Rehabil, New Haven, CT USA
关键词
revision total knee arthroplasty; octogenarian; American College of Surgeons National; Surgical Quality Improvement Program; postoperative adverse events; readmission; TOTAL HIP-ARTHROPLASTY; TOTAL JOINT ARTHROPLASTY; OLDER PATIENTS; UNITED-STATES; ADVANCED AGE; COMPLICATIONS; REPLACEMENT; MORTALITY; OUTCOMES; SURGERY;
D O I
10.1016/j.arth.2017.07.032
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The number of octogenarians undergoing revision total knee arthroplasty (TKA) is increasing. However, there has been a lack of studies investigating the perioperative course and safety of revision TKA performed in this potentially vulnerable population in a large patient population. The purpose of this study is to compare complications following revision TKA between octogenarians and 2 younger patient populations (<70 and 70-79 year olds). Methods: Patients who underwent revision TKA were identified in the 2005-2015 National Surgical Quality Improvement Program database and stratified into 3 age groups: <70, 70-79, and >= 80 years. Baseline preoperative and intraoperative characteristics were compared between the 3 groups. Propensity score matched comparisons were then performed for 30-day perioperative complications, length of hospital stay, and readmissions. Results: This study included 6523 (<70 years), 2509 (70-79 years), and 957 octogenarian patients who underwent revision TKA. After propensity matching, statistical analysis revealed only higher rates of blood transfusion and slightly longer length of stay in octogenarians compared to <70 year olds. Similarly, octogenarians had only higher rates of blood transfusion and slightly longer length of stay compared to 70-79 year olds. Notably, there were no differences in mortality or readmission between octogenarians compared to younger populations. Conclusion: These data suggest that revision TKA can safely be considered for octogenarians with the observation of higher rates of blood transfusion and slightly longer length of stay compared to younger populations. Octogenarian patients need not be discouraged from revision TKA solely based on their advanced age. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:178 / 184
页数:7
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