Risk and complication profiles of orthogeriatric patients in elective hip and knee joint replacement

Abstract

The care of geriatric patients undergoing elective orthopedic surgery is becoming increasingly more important due to demographic trends. Compared to geriatric traumatology, however, there are still no established orthogeriatric care models in Germany and therefore hardly any scientific data. The aim of this study was to describe the risk and complication profiles in older patients with elective hip and knee replacements. In aprospective study data were collected from orthogeriatric patients with indications for elective hip and knee replacement surgery who fulfilled defined inclusion and exclusion criteria between January 2021 and August 2023 in the orthopedic department of aGerman university hospital for the descriptive analysis of risk and complication profiles. In addition to apreoperative and perioperative data analysis, afollow-up was conducted 4-6weeks and 3months postoperatively. The surgical risk profile of the patient population analyzed was characterized by advanced age (78.4 ± 4.8years), preobesity/obesity (76%), multimorbidity (7.4 ± 3.1 comorbidities), polypharmacy (7.5 ± 3.8 medications), immobility (short physical performance battery 7.1 ± 2.6), prefrailty/frailty (87%), frequent anticoagulation (22%) and ahigh number of potentially inappropriate medications (64%). Complication events mainly occurred within the first 7days postoperatively and 90% of the events within this recording period were minor complications. The overall complication rate significantly decreased in the follow-up period. Due to the high risk and complication profiles the routine use of orthogeriatric co-management models for elective orthopedic surgery should be considered in the future.