{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:46:04Z","timestamp":1791985564572,"version":"4.4.0"},"reference-count":60,"publisher":"SLACK, Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prior studies evaluating age-related outcomes after total knee arthroplasty (TKA) have examined medical complications and revision risk separately. We asked whether octogenarians have higher rates of 90-day medical complications, 30- and 90-day readmissions, and all-cause and etiology-specific revision after primary TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>PearlDiver all-payer claims (2010 to 2022) identified isolated, first-instance unilateral primary TKA, excluding index revision, fracture\/malignancy, concomitant other-joint arthroplasty, staged\/simultaneous bilateral TKA within 30 days, and prior arthroplasty within 1 year. Patients were stratified by age (&lt;65, 65 to 79, 80 to 89 years). Outcomes included 90-day medical complications, 30- and 90-day readmissions, and 1-year all-cause and etiology-specific revision (ie, prosthetic joint infection, mechanical loosening, instability\/dislocation, periprosthetic fracture). Multivariable logistic and Cox regression adjusted for sex, Elixhauser Comorbidity Index, and body mass index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 376,914 TKAs with complete covariate data, octogenarians had higher adjusted odds of 90-day medical complications and 30- and 90-day readmissions (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Patients &lt;65 years had the highest 1-year all-cause revision and higher adjusted odds of all-cause revision, prosthetic joint infection, and mechanical loosening or instability\/dislocation revision, whereas octogenarians had a higher hazard of revision for periprosthetic fracture (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Octogenarians experienced greater early medical morbidity but lower observed 1-year revision hazards than did younger patients. These findings support age-calibrated counseling emphasizing perioperative optimization in older patients while informing younger patients of their greater early revision risk. Because mortality was unavailable as a competing event, lower revision hazards in octogenarians should be interpreted cautiously and not assumed to reflect superior implant durability. Future studies incorporating competing-risk methodology, frailty measures, and patient-reported outcomes are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3928\/01477447-20260820-01","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:13:12Z","timestamp":1790169192000},"source":"Crossref","is-referenced-by-count":0,"title":["Octogenarians Face Higher 90-day Medical Risk but Lower 1-year Revision Rates After Primary Total Knee Arthroplasty"],"prefix":"10.3928","volume":"49","author":[{"given":"Gerald Y.","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Chansky","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Manner","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin D.","family":"Fernando","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermyas A.","family":"Kahsai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.39692"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.O.00064"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2019.04.001"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2025.101727"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.03.040"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.05.046"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2985-8"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2151459318804113"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.04.073"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02358-w"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.06.009"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-05294-7"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","unstructured":"Benito J Stafford J Judd H Ng M Corces A Roche MW. 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