Single-staged bilateral total knee arthroplasty: the role of elderly age (70+ years) on perioperative complications
Murat Hersekli Ali, Sercan Akpınar, Gürkan Özkoç, Metin Özalay, Necip Cesur, Mustafa Uysal, Reha N Tandoğan
Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Adana
Keywords: Aged; arthroplasty, replacement, knee/contraindications/ methods; intraoperative complications; knee joint; knee prosthesis; osteoarthritis, knee/surgery; risk factors.
Objectives: We investigated the effect of age on perioperative complications encountered in bilateral total knee arthroplasty operations performed at a single stage.
Patients and methods: Thirty-nine patients with bilateral osteoarthritis underwent single-staged bilateral total knee arthroplasty. The patients were divided into two groups depending on the age, i.e. above (n=19; mean age 73.4 years; range 70 to 88 years) or below (n=20; mean age 63.1 years; range 52 to 68 years) 70 years. Coexisting diseases prior to surgery were recorded. The two groups were compared with regard to neurologic, cardiovascular, and gastrointestinal complications; blood loss and transfusion requirements, and length of hospitalization.
Results: The mean ages were significantly different between the two age groups (p=0.001). Blood loss and transfusion requirements did not differ significantly. Although the mean hospital stay was less in the younger group (mean 8.75 days versus 12.32 days), this did not reach significance (p>0.05). No perioperative complications were encountered in the younger group, whereas three patients (15.8%) and one patient (5.3%) developed neurologic and cardiovascular complications, respectively, and one patient died of acute renal failure in the older group (p=0.02).
Conclusion: Age above 70 years is a significant risk factor for the development of perioperative complications in single-staged bilateral total knee arthroplasty operations.