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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...

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Autores principales: Courage, Olivier, Strom, Louise, van Rooij, Floris, Lalevée, Matthieu, Heuzé, Donatien, Papin, Pierre Emanuel, Butnaru, Michael, Müller, Jacobus Hendrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2021
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
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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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