“If you make it into your 90s, you must have something going for you that helps you do well with surgery,” says Dr. Miric. “I think you have to stop looking at age as an indicator and look at how robust the person’s health is.”

The oldest patients did have an almost 10 percent greater risk of being readmitted to the hospital within 90 days, either due to surgery complications (such as urinary tract infections) or other reasons, compared to patients younger than 80. “It may just take longer for them to recover from this surgery, and we have to keep a close eye for a longer period before we can conclude that they’ve successfully recovered,” says Dr. Miric.

Why would a surgeon put a new hip in someone nearing the end of life? “They have pain and disability and it can have a severe impact on their quality of life and their ability to take care of themselves,” says Dr. Miric. “They may need it in some cases even more than someone who’s younger.”

Michael Parks, MD, associate attending orthopaedic surgeon at the Hospital for Special Surgery in New York, agrees. “We’re really seeing more patients over 90 years old that come in and they’re in pretty good health, but they have an aching knee or hip. It’s a quality-of-life issue. There are people that may be otherwise functional, able to do things, care for themselves, and they’re becoming progressively less able to do those things because of a painful hip.”

Dr. Parks called the mortality rate in the study small. “I would agree with the author’s conclusion, and that’s what we can take away from [the study]: These patients can safely undergo total hip replacement when compared to younger groups of patients.”

An Implant May Last a Lifetime

The second study involved a group of people who got their hip implants when they were between ages 18 and 49. Researchers have been checking on them periodically for 35 years to see how they and their implants were faring.

“We’ve been following them throughout the years,” says study co-author Lucian C. Warth, MD, a senior orthopaedic surgery resident in the department of orthopaedic surgery at University of Iowa Health in Iowa City. “It’s the longest study as far as follow-up goes of any total hip replacement yet.”