Department of General Orthopaedics, Auguste-Viktoria-Clinic Bad Oeynhausen, University Hospital of RUB-Bochum, Am Kokturkanal, 32545 Bad Oeynhausen, Germany
Department of General Orthopaedics, Auguste-Viktoria-Clinic Bad Oeynhausen, University Hospital of RUB-Bochum, Am Kokturkanal, 32545 Bad Oeynhausen, Germany.
Clin Med Res. 2023 Sep;21(3):136-143. doi: 10.3121/cmr.2023.1810.
Knee arthroplasty is exposed to demographic changes as patients age. An analysis of risk factors for surgical treatment decisions in patients over 80 years old is crucial. This study compared perioperative complications between groups of patients undergoing primary knee arthroplasty, under 60 years old and over 80 years old. For this retrospective study, data from 400 patients with primary cemented bi- and unicondylar total knee endoprosthesis during inpatient stay from 2017 to 2018 were analyzed. Patients aged 61-79 years (257) were excluded. An analysis of the remaining 143 patients was performed. The incidence of surgery-related and systemic complications (eg, urinary tract infections, electrolyte imbalances, and cases of pneumonia), the blood supply and C-reactive protein (CRP) as well as hemoglobin progression were compared across both age groups. Furthermore, a correlation between prevalent diseases and systemic complications were investigated. Statistical analysis was performed using IBM SPSS (Armonk, US). Data analyses showed a significant difference in the occurrence of systemic complications and blood transfusion between the age groups ( = 0.001, phi = 0.44; phi= 0.55, = 0.001). Surgical complications did not differ significantly between the age groups. Age-typical pre-existing conditions, especially arterial hypertension ( = 0.003), showed a significant association with the occurrence of systemic complications. In addition, high postoperative CRP values in elderly patients revealed an association to systemic complications ( = 0.008). The study shows that primary cemented knee arthroplasty is a safe procedure without an increased incidence of surgical complications, even in elderly patients. The increased incidence of internal complications in octogenarians, in turn, should receive more attention in the perioperative course. The interdisciplinary preoperative optimization of pre-existing conditions and drug therapy, as well as close interdisciplinary assessments of elderly patients, should be ensured.
膝关节置换术因患者年龄增长而面临人口结构变化的影响。对 80 岁以上患者手术治疗决策的风险因素进行分析至关重要。本研究比较了行初次膝关节置换术的 60 岁以下和 80 岁以上患者围手术期并发症。本回顾性研究分析了 2017 年至 2018 年期间在院接受初次骨水泥固定双髁和单髁全膝关节假体的 400 例患者的数据。排除了年龄在 61-79 岁之间的 257 例患者。对其余 143 例患者进行了分析。比较了两组患者的手术相关和全身并发症（如尿路感染、电解质失衡和肺炎病例）、血液供应和 C 反应蛋白（CRP）以及血红蛋白的变化。此外，还调查了常见疾病与全身并发症之间的相关性。采用 IBM SPSS（美国阿蒙克）进行统计分析。数据分析显示，两组患者全身并发症和输血的发生率存在显著差异（=0.001，phi=0.44；phi=0.55，=0.001）。两组患者手术并发症无显著差异。年龄相关的常见疾病，特别是动脉高血压（=0.003），与全身并发症的发生有显著关联。此外，老年患者术后 CRP 值升高与全身并发症相关（=0.008）。本研究表明，初次骨水泥固定膝关节置换术是一种安全的手术，即使在老年患者中，手术并发症的发生率也没有增加。高龄患者内部并发症发生率的增加，在围手术期应受到更多关注。应确保进行跨学科的术前优化治疗，包括对合并症和药物治疗的干预，以及对老年患者的密切跨学科评估。
