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Total Joint Replacement in the Past Does Not Relate to a Deteriorated Functional Level and Health Status in the Oldest Old

DOI: 10.1155/2012/968389

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Abstract:

Total hip or knee replacement is effective in improving joint function, quality of life, and pain reduction. The oldest old population with joint replacements (TJR) is underrepresented in current literature. We compared health-related and functional characteristics of oldest olds with and without TJR. Participants (aged 85 years) were divided into a group with and without TJR. Comorbidity, physical and joint functioning, daily living activities, quality of life, and mortality were recorded. Thirty-eight of 599 participants (6.3%) received a TJR in the past. Participants with a TJR had slightly less comorbidities, walked slower ( ?? = 0 . 0 0 6 ), and complained more about hip-pain ( ?? = 0 . 0 0 7 ). Mortality of those with a TJR was lower during the first 8-year followup ( ?? = 0 . 0 4 ). All other characteristics were comparable between groups. We conclude that subjects with a TJR performed equally well, besides showing a lower gait speed and a higher frequency of hip-pain. Except for the lower gaitspeed, having a TJR is not associated with poorer health. 1. Introduction The population of oldest olds (i.e., 85 years and older) is the fastest growing segment of the elderly population in the western society [1]. The health status decreases with increasing chronological age [2]. One of the major age-related diseases is osteoarthritis (OA), which is more common in females [3–5]. In subjects between 60 and 70 years of age, prevalences of symptomatic knee OA are reported of approximately 10 percent in males and 20 percent in females [4]. Prevalence of knee OA is comparable in subjects aged 80 years and older [4, 5]. Symptomatic OA of the hip is present in approximately five percent of the 60 to 70 years old females and up to 18 percent in females of 80 years and older. In males, prevalences are slightly lower [3, 4]. Due to the demographic changes, the number of total hip replacement (THR) and total knee replacement (TKR) procedures steadily increases [6]. Increasing age is associated with a higher complication and mortality rate after total joint replacement [6]. However, the results of total joint replacement in elderly patients have been proven effective in terms of pain reduction, functional improvement, and cost-effectiveness and show similar results compared to younger patients receiving total joint replacement [7, 8]. OA of the hip or the knee impairs physical activity [4]. Restriction of physical activity is associated with numerous detrimental effects on general health status, physical function, and quality of life [4, 9]. Maintaining physical

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