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Risks, Benefits and Economic Consequences of Total Hip Arthroplasty in an Aged Population

Sven-Arne Jacobsson, Department of Orthopaedic Surgery, University of Linköping, Sweden, Address for offprints: S.-A. Jacobsson, MD, Department of Orthopaedic Surgery, University Hospital of Linköping, S-581 85 Linköping, Sweden Tel. 4613-191000

Clas Rehnberg

Center for Medical Technology Assessment, University of Linköping, Sweden

Krister Djerf

Department of Orthopaedic Surgery, University of Linköping, Sweden

An attempt was made to evaluate risks, benefits and costs of total hip replacement in patients over 80 years. Forty consecutive replacements in 37 patients were analysed and the results were compared to a younger population (36 patients) concerning complications and duration of hospitalization. The elderly group was reexamined two years postoperatively to assess the outcome. There was a significantly prolonged stay in hospital/long-term care for the octogenarians, 31.1 days compared to 13.6 for the younger group, as well as an increased risk for complications. Eleven patients had 18 different complications (11/40; 27.5%) in contrast to 2 complications in 2 patients (2/36; 5.6%) in the younger population. Quality of life was increased in terms of pain relief and there was moderate improvement in function. For the elderly, the community expenses for welfare services were not found to be reduced after the intervention. It is concluded that the observed improvement of quality of life has to be balanced against the increased risks and costs for this group.

Key Words: Total hip replacement • complications • elderly • cost analysis.

Scandinavian Journal of Public Health, Vol. 19, No. 1, 72-78 (1991)
DOI: 10.1177/140349489101900113


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