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Mayo Clinic study finds total hip replacement among older patients provides better quality of life

John Murphy

EurekAlert, March 14, 2003


Results of a study of 65 patients who underwent total hip replacement surgery at Mayo Clinic show that the procedure can be done safely and effectively in patients 90 years and older, and provide them years of improved quality of life.

Mayo Clinic researchers discuss their results in the March issue of Mayo Clinic Proceedings. The results provide important information as baby boomers age, increasing the number of people who will require total hip replacement in their 90s. Other patients who are 90 and older will require a second total hip replacement.

"Primary-care physicians and surgeons should be aware that both primary and revision total hip replacement can be done safely and effectively in patients 90 years old and older and can result in years of pain relief and functional improvement," said Mark Pagnano, M.D., Mayo Clinic orthopedic surgeon and an author of the study. "In our study, the typical patient lived for more than five years after hip replacement and had substantial relief of pain and improvement of function during that period."

Researchers reviewed the medical records of 65 patients, 90 years and older, who had total hip replacement surgery -- both primary or a revision of a previous surgery -- from 1970 to 1997.

Dr. Pagnano notes that there were medical and surgical complications but that they seldom compromised the outcome of the operation. He says that patients in this age category often have medical conditions, such as hypertension, anemia or a history of cardiac disease, which make the surgery more challenging. With that in mind, he says it's important for patients to be monitored closely for medical complications in the early postoperative period.

Authors of the study along with Dr. Pagnano included Lori McLamb and Robert Trousdale, M.D., Mayo Clinic Department of Orthopedic Surgery.

In an editorial in the same issue of Mayo Clinic Proceedings, James O'Brien, M.D., of the Department of Family and Community Medicine at the University of Louisville Health Sciences Center, writes that the study "provides a glimpse into the future and highlights the challenge that physicians, orthopedists in particular, are likely to confront."

Dr. O'Brien notes that the most rapidly growing segment of the United States' population is the group 85 years and older.

"But perhaps even more dramatic is the increase in centenarians (those age 100 and older) with a predicted doubling each decade in the future," Dr. O'Brien said. "Thus, treatment of this age group will become much more commonplace."

Dr. O'Brien said the most important findings of the study are related to reduction of pain, restoration of function and patient satisfaction -- all valued outcomes in the care of older patients.

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Mayo Clinic Proceedings is a peer-reviewed and indexed general internal medicine journal, published for more than 75 years by Mayo Foundation, with a circulation of 130,000 nationally and internationally.


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