There is limited literature regarding the outcome of hip and knee arthroplasty (THR and TKR) in the Super-Elderly (≥80yrs). The aim is to compare the outcome of THR and TKR in the Super-Elderly with a standard-age cohort of patients. From January 2006 to August 2008; 1290 TKR and 1344 THR were performed at the study institute. Comorbidity, length of stay, patient satisfaction, Oxford knee or hip scores, and SF12 scores were recorded prospectively. The Oxford Score and SF12 were recorded at one year. The mode age range was 65-74yrs for TKR (n=492) and THR (n=495), deemed the standard cohort. 185 TKR and 171 THR were performed in the Super-Elderly. Outcome in this cohort was compared to the standard. The standard cohort had a greater absolute improvement in Oxford knee scores (15.8 and 14.7.p=0.2). Improvement of absolute Oxford hip scores revealed no difference (20.0 and 20.2.p=0.8), but the Super-Elderly had a greater improvement in pain components (11.0 vs.12.0.p=0.05) with a lesser improvement of the functional components (9.0.vs.8.2.p=0.05). There was a greater improvement in the physical component of the SF-12 score in the standard cohort for both TKR and THR (10.6.vs.7.9.p=0.05 and 14.4.vs.10.4.p=<0.01, respectively). No significant difference was seen in comorbidities, but the Super-Elderly patients had a longer hospital stay for TKR (6.2.vs.8.3.p=0.01) and THR (5.9.vs.9.0.p=0.01). The Super-Elderly were more satisfied with their surgery (p=0.05). Super-Elderly patients have comparable outcomes to their younger counterparts and are more satisfied with their surgery, but they may require a longer length of stay

The epidemiology of adult fractures is changing rapidly. The longevity of the population continues to extend with increasing incidence of fragility fractures. The aim of this study was to map the epidemiology of fractures in patients 90 years and older. A retrospective review of all orthopaedic trauma patients over the age of 89 years attending Edinburgh Royal Infirmary in 2000 was performed. All inpatients and outpatients were included. These patients were identified using a prospectively complied database held by the senior author. Patient notes were used to confirm place of residence, mobility, co-morbidity, management, length of admission and place of discharge. 236 fractures (4% of all fractures) were identified. There were 209 (89%) female patients. All were secondary to low energy trauma. More than 50% of the patients were admitted from home and mobilised independently or with a stick. 124 (53%) patients had nil or one co-morbidity, the commonest being dementia and hypertension. Of the 133 neck of femur (NOF) fractures 11 (8%) died as inpatients, and of the 66 patients residing independently in their own home only 5 (8%) returned with the other 61 needing step-up care. The average length of stay in hospital for NOF fractures was 13 days. The majority of patients are female and reside at home, being independently mobile and have limited co-morbidity. The length of stay is relatively long and few patients’ return directly home following a NOF fracture. This, with the ever-growing super-elderly population, will have substantial financial implications in the future