Arthroplasty in the octogenarian: quantifying the risks

The objective of this study was to determine the risk of complications after primary total hip and knee arthroplasties in octogenarians. Using administrative data, we compared the rate of complications for octogenarians vs patients aged 65 to 79 years who underwent total hip or knee arthroplasty in Ontario between 1993 and 1997. Octogenarians were 3.4 times more likely to die, 2.7 times more likely to sustain a myocardial infarction, and 3.5 times more likely to develop pneumonia. Postoperative confusion and urinary tract infections were also significantly more common in octogenarians. Octogenarians are at higher risk for death and serious complications after primary joint arthroplasty. However, the overall event rate remains low and total joint arthroplasty surgery should continue to be offered to these individuals provided that the complication rates are acceptable to the patients and their families.