Knee Alternative in People Over 80: Much less Dangerous Than You Suppose

TUESDAY, March 22, 2022 (HealthDay Information)

Knee substitute surgical procedure is more and more widespread amongst individuals over 80 sidelined with knee ache, and the process is not as hazardous for them as typically assumed.

That is the primary message from a brand new research of greater than 1.7 million seniors who underwent knee substitute surgical procedure.

The findings come as no shock to Dr. Thomas Fleeter, whose oldest knee substitute affected person was 96.

Age is only a quantity with regards to knee substitute surgical procedure, stated Fleeter, an orthopedic surgeon with workplaces in Reston and Centreville, Va. He was not concerned with the brand new research.

“No person needs to stay in ache, and one of many biggest fears of aged individuals is being dependent,” he stated. These people need to go to the grocery retailer, see their grandchildren, journey, backyard and stay their lives to the fullest, he added.

For a lot of of them, knee substitute surgical procedure can assist meet these objectives.

Octogenarians do have longer hospital stays after knee substitute surgical procedure and are additionally extra prone to be readmitted to the hospital inside 90 days than sufferers aged 65 to 79, however the two age teams are inclined to have comparable dangers for different problems, the research group discovered.

“We’re seeing a rise in life expectancy, and extra individuals need to maintain a great high quality of life and exercise, so sufferers older and older are contemplating knee substitute as a option to overcome persistent knee ache,” stated research writer Priscilla Varghese, a medical scholar at SUNY Downstate in New York Metropolis.

Varghese carried out the research at Maimonides Medical Heart, in Brooklyn, throughout a summer season analysis program. “Knee substitute surgical procedure carries a really low threat for individuals aged 80 and older, and they’ll seemingly have a considerable, if not full, discount of ache after surgical procedure,” Varghese stated.

The brand new findings might change the way in which older persons are endorsed concerning the dangers and advantages of knee substitute, she added.

For the research, the researchers analyzed medical claims knowledge on greater than 1.7 million individuals aged 65 and older who bought a brand new knee. The investigators in contrast complication charges amongst individuals aged 80 and older to these skilled by sufferers aged 65 to 79.

Charges of readmission and size of hospital keep have been larger and longer amongst octogenarians, the outcomes confirmed.

Each age teams had comparable dangers for medical problems (equivalent to pneumonia and different infections) within the 90 days following their surgical procedure.

However people aged 80 and up had decrease charges of implant-related problems — equivalent to erosion, an infection, implant failure and mechanical loosening — than their youthful counterparts after two years.

This is sensible, she stated: “The youthful group of sufferers could also be extra energetic so that they have a better threat of damage and tear on the {hardware}.”

Surgical procedure is not the one choice for these older sufferers. Different remedies equivalent to weight reduction or steroid injections could assist, however knee ache sometimes does not get higher by itself, Varghese stated.

The findings have been scheduled for presentation on the annual assembly of the American Academy of Orthopaedic Surgeons, held March 22 to 26 in Chicago. Findings offered at medical conferences ought to be thought of preliminary till printed in a peer-reviewed journal.

Not each 80-plus-year-old is a candidate for knee substitute, Fleeter famous. “In case you are obese and produce other pre-existing well being circumstances, the chance of knee substitute surgical procedure could also be too excessive,” he stated.

However “an 83-year-old who’s skinny and in any other case wholesome, but cannot stroll from his automotive to the door resulting from knee ache, will in all probability sail by way of this operation.”

The underside line? “Age is not the difficulty,” he stated. “It is all the opposite figuring out components that go into it.”

Extra data

The American Academy of Orthopaedic Surgeons tells you what to anticipate after knee substitute surgical procedure.

SOURCES: Priscilla Varghese, medical scholar, SUNY Downstate, New York Metropolis; Thomas Fleeter, MD, orthopedic surgeon, Reston and Centreville, Va.; American Academy of Orthopaedic Surgeon’s annual assembly, Chicago, March 22 to 26, 2022

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