Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
J Arthroplasty. 2012 Oct;27(9):1599-603. doi: 10.1016/j.arth.2012.03.007. Epub 2012 Apr 30.
A retrospective cohort study and a comparative literature review were undertaken to determine outcomes and survival/mortality rates among nonagenarian patients who underwent total joint arthroplasty (TJA). Thirty-nine patients who underwent TJA (14 hips, 25 knees) aged 90+ years were identified from a database of 9817 primary TJA cases performed at one hospital between 1998 and 2010. Findings were compared to synthesized data from relevant published literature review (LR). The mean age was 91.3 (±1.4) years, 79.5% were rated by the American Society of Anesthetists as 3+. Medical complication rate was 25.6% vs 36.2% for LR cases (P = .219). Perioperative death rate was 2.6% vs 2.1% among LR cases (P = 1.000). At 3.8-year follow-up, mortality rate was 59% (LR, 58.2%; 5.1 years), with a mean age of 95.2 (±3.5) years at death (LR, 96.3 ± 3.4). Excellent clinical outcomes were achieved. Primary TJA remains a viable and effective procedure in nonagenarian patients.
一项回顾性队列研究和文献复习比较，旨在确定接受全关节置换术（TJA）的 90 岁以上患者的结局和生存率/死亡率。从 1998 年至 2010 年在一家医院进行的 9817 例初次 TJA 病例数据库中，确定了 39 例接受 TJA（14 髋，25 膝）的 90 岁以上患者。研究结果与从相关文献复习（LR）中综合得出的数据进行了比较。平均年龄为 91.3（±1.4）岁，79.5%的患者被美国麻醉师协会评为 3+。并发症发生率为 25.6%，LR 病例为 36.2%（P =.219）。围手术期死亡率为 2.6%，LR 病例为 2.1%（P = 1.000）。在 3.8 年的随访中，死亡率为 59%（LR 为 58.2%；5.1 年），死亡时的平均年龄为 95.2（±3.5）岁（LR 为 96.3 ± 3.4）。取得了良好的临床效果。初次 TJA 仍然是 90 岁以上患者可行且有效的治疗方法。
