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Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies
The purpose of this systematic review was to synthesize studies published since the last systematic review in 2015 that compare outcomes of primary total knee arthroplasty (TKA) in older patients (≥ 80 years) and in younger patients (< 80 years), in terms of complication rates and mortality. An e...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
British Editorial Society of Bone and Joint Surgery
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631241/ https://www.ncbi.nlm.nih.gov/pubmed/34909224 http://dx.doi.org/10.1302/2058-5241.6.200150 |
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author | Courage, Olivier Strom, Louise van Rooij, Floris Lalevée, Matthieu Heuzé, Donatien Papin, Pierre Emanuel Butnaru, Michael Müller, Jacobus Hendrik |
author_facet | Courage, Olivier Strom, Louise van Rooij, Floris Lalevée, Matthieu Heuzé, Donatien Papin, Pierre Emanuel Butnaru, Michael Müller, Jacobus Hendrik |
author_sort | Courage, Olivier |
collection | PubMed |
description | The purpose of this systematic review was to synthesize studies published since the last systematic review in 2015 that compare outcomes of primary total knee arthroplasty (TKA) in older patients (≥ 80 years) and in younger patients (< 80 years), in terms of complication rates and mortality. An electronic literature search was conducted using PubMed, Embase®, and Cochrane Register. Studies were included if they compared outcomes of primary TKA for osteoarthritis in patients aged 80 years and over to patients aged under 80 years, in terms of complication rates, mortality, or patient-reported outcomes (PROs). Thirteen studies were eligible. Surgical complications in older patients ranged from 0.6–21.1%, while in younger patients they ranged from 0.3–14.6%. Wound complications in older patients ranged from 0.5–20%, while in younger patients they ranged from 0.8–22.0%. Medical complications (cardiac, respiratory, thromboembolic) in older patients ranged from 0.4–17.3%, while in younger patients they ranged from 0.2–11.5%. Mortality within 90 days in older patients ranged between 0–2%, while in younger patients it ranged between 0.0–0.03%. Compared to younger patients, older patients have higher rates of surgical and medical complications, as well as higher mortality following TKA. The literature also reports greater length of stay for older patients, but inconsistent findings regarding PROs. The present findings provide surgeons and older patients with clearer updated evidence, to make informed decisions regarding TKA, considering the risks and benefits within this age group. Patients aged over 80 years should therefore not be excluded from consideration for primary TKA based on age alone. Cite this article: EFORT Open Rev 2021;6:1052-1062. DOI: 10.1302/2058-5241.6.200150 |
format | Online Article Text |
id | pubmed-8631241 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | British Editorial Society of Bone and Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-86312412021-12-13 Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies Courage, Olivier Strom, Louise van Rooij, Floris Lalevée, Matthieu Heuzé, Donatien Papin, Pierre Emanuel Butnaru, Michael Müller, Jacobus Hendrik EFORT Open Rev Knee The purpose of this systematic review was to synthesize studies published since the last systematic review in 2015 that compare outcomes of primary total knee arthroplasty (TKA) in older patients (≥ 80 years) and in younger patients (< 80 years), in terms of complication rates and mortality. An electronic literature search was conducted using PubMed, Embase®, and Cochrane Register. Studies were included if they compared outcomes of primary TKA for osteoarthritis in patients aged 80 years and over to patients aged under 80 years, in terms of complication rates, mortality, or patient-reported outcomes (PROs). Thirteen studies were eligible. Surgical complications in older patients ranged from 0.6–21.1%, while in younger patients they ranged from 0.3–14.6%. Wound complications in older patients ranged from 0.5–20%, while in younger patients they ranged from 0.8–22.0%. Medical complications (cardiac, respiratory, thromboembolic) in older patients ranged from 0.4–17.3%, while in younger patients they ranged from 0.2–11.5%. Mortality within 90 days in older patients ranged between 0–2%, while in younger patients it ranged between 0.0–0.03%. Compared to younger patients, older patients have higher rates of surgical and medical complications, as well as higher mortality following TKA. The literature also reports greater length of stay for older patients, but inconsistent findings regarding PROs. The present findings provide surgeons and older patients with clearer updated evidence, to make informed decisions regarding TKA, considering the risks and benefits within this age group. Patients aged over 80 years should therefore not be excluded from consideration for primary TKA based on age alone. Cite this article: EFORT Open Rev 2021;6:1052-1062. DOI: 10.1302/2058-5241.6.200150 British Editorial Society of Bone and Joint Surgery 2021-11-19 /pmc/articles/PMC8631241/ /pubmed/34909224 http://dx.doi.org/10.1302/2058-5241.6.200150 Text en © 2021 The author(s) https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Knee Courage, Olivier Strom, Louise van Rooij, Floris Lalevée, Matthieu Heuzé, Donatien Papin, Pierre Emanuel Butnaru, Michael Müller, Jacobus Hendrik Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title | Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title_full | Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title_fullStr | Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title_full_unstemmed | Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title_short | Higher rates of surgical and medical complications and mortality following TKA in patients aged ≥ 80 years: a systematic review of comparative studies |
title_sort | higher rates of surgical and medical complications and mortality following tka in patients aged ≥ 80 years: a systematic review of comparative studies |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631241/ https://www.ncbi.nlm.nih.gov/pubmed/34909224 http://dx.doi.org/10.1302/2058-5241.6.200150 |
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