Geriatric Orthopaedic Surgery & Rehabilitation最新文献

{"title":"Association Between Multimorbidity and Walking Independence After Total Knee Arthroplasty in Adults Aged ≥80 Years: A Retrospective Cohort Study.","authors":"Makoto Asaeda, Yukio Mikami, Atsuo Nakamae, Tomoyuki Nakasa, Akinori Nekomoto, Noriaki Maeda, Kiyo Ueda, Takeya Araki, Nobuo Adachi","doi":"10.1177/21514593261446118","DOIUrl":"10.1177/21514593261446118","url":null,"abstract":"<p><strong>Background: </strong>The demand for total knee arthroplasty, an established treatment for advanced knee osteoarthritis, is anticipated to increase among individuals aged ≥80 years. Given the high prevalence of multimorbidity among older adults in Japan, in this study, we aimed to elucidate the relationship between multimorbidity and post-operative walking independence in this demographic.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent total knee arthroplasty for knee osteoarthritis between October 2023 and September 2024; those who underwent other surgeries or had significant mobility limitations were excluded. Patients aged ≥80 years with a Charlson Comorbidity Index of ≥2 were categorized into the \"older patients with multimorbidity\" group. The primary outcome was walking independence, which was assessed using the Functional Ambulation Category. Demographic and clinical variables were evaluated as potential confounders. Statistical tests included Student's <i>t</i>-test, Mann-Whitney <i>U</i> test, chi-square test, and hierarchical multiple regression analysis; a <i>p</i>-value of <0.05 was considered significant.</p><p><strong>Results: </strong>Thirteen and 42 patients were classified as \"older patients with multimorbidity\" and controls, respectively. Significant intergroup differences were observed in age, height, weight, and hemoglobin levels but not in the length of hospital stay and overall outcomes. Functional Ambulation Category scores declined postoperatively in both groups, with no significant intergroup difference in independent walking ability. Hierarchical multiple regression analysis of pooled data revealed no significant association between age or multimorbidity and walking independence at discharge.</p><p><strong>Conclusion: </strong>The findings indicate that age and multimorbidity are not primary determinants of post-operative walking independence. Individualized rehabilitation may improve recovery outcomes, underscoring the potential benefits of standardizing postoperative care for older patients with multimorbidity who have undergone total knee arthroplasty.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261446118"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Fixation Method and Surgical Approach on Outcomes Following Hip Hemiarthroplasty for Femoral Neck Fracture.","authors":"Brian D Rust, Mitchel R Obey, Jenna-Leigh Wilson, Christopher M McAndrew, Marschall B Berkes","doi":"10.1177/21514593261446117","DOIUrl":"10.1177/21514593261446117","url":null,"abstract":"<p><strong>Introduction: </strong>Hip hemiarthroplasty is commonly performed for displaced femoral neck fractures in older adults, with implants placed either cemented or uncemented. While cemented fixation offers immediate stability, uncemented fixation reduces operative time and pulmonary complications. Large single-center analyses comparing these techniques remain limited, and this study aims to assess this.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study of 634 adult patients undergoing hip hemiarthroplasty at a single Level 1 trauma center from 2019 to 2025. Patients were classified by cemented (n=403) or uncemented (n=231) fixation and further stratified by surgical approach (anterolateral vs posterior). Outcomes included length of stay, postoperative complications, return to baseline mobility (Koval score), discharge destination, and postoperative mortality within 1 year. Statistical analyses were conducted to evaluate predictive factors with independent-samples t-tests, Mann-Whitney U tests, Chi-square tests, and logistic regression utilized where appropriate.</p><p><strong>Results: </strong>Baseline demographics and preoperative mobility were similar between cohorts. Cemented hips with anterolateral approaches had the lowest rates of dislocation (1.3%, p=0.036) and revision surgery (1.7%, p=0.024), but this did not remain significant after statistical correction (p=0.228, p=156). Functional recovery was comparable across groups. Cemented fixation independently predicted discharge home (OR 2.17, p=0.002). There were no significant differences in length of stay, postoperative pain, periprosthetic fracture, infection, readmission, or mortality within 1 year.</p><p><strong>Conclusions: </strong>In this large single-center cohort, cemented hip hemiarthroplasty, particularly with an anterolateral approach, was associated with reduced dislocation and revision rates and increased likelihood of discharge home. These findings support consideration of cemented fixation with an anterolateral approach in appropriately selected patients to optimize postoperative outcomes and quality of life. Further multicenter prospective studies are warranted to confirm these results and refine surgical decision-making for femoral neck fractures.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261446117"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: \"The Critical Role of Follow-Up in Fracture Liaison Services for Geriatric Hip Fracture Patients: A Retrospective Cohort Study\" - Israeli Eilon et al (2026).","authors":"Cátia Ganito","doi":"10.1177/21514593261441090","DOIUrl":"10.1177/21514593261441090","url":null,"abstract":"","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261441090"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Clinical Outcomes in Frail Patients Who Underwent Short Lumbar Fusion Surgery With the Implementation of the Enhanced Recovery After Surgery (ERAS) Protocol.","authors":"Tinh Laoharojanaphand, Panlop Tirawanish, Monchai Ruangchainikom, Werasak Sutipornpalangkul, Ekkapoj Korwutthikulrangsri","doi":"10.1177/21514593261442735","DOIUrl":"10.1177/21514593261442735","url":null,"abstract":"<p><strong>Background: </strong>Frailty among surgical patients correlates with the risks of adverse outcomes, including postoperative complications, extended recovery, and elevated mortality rates. The ERAS protocol is a comprehensive, team-based care pathway that focuses on refining perioperative management, lowering the risk of complications, and promoting faster recovery. This study investigates the effects of implementing ERAS on hospitalization duration, clinical outcomes, and perioperative complications in frail individuals undergoing short-segment lumbar fusion.</p><p><strong>Methods: </strong>We included frail patients ≥65 years who underwent one- or two-level posterior lumbar fusion for degenerative spinal disease from January 2018 to October 2020 (non-ERAS cohort) and from October 2020 to June 2023 (ERAS cohort). Demographic information, comorbidities, and surgical details were collected. The primary outcome was to compare the hospitalization duration. Additionally, other clinical outcomes, such as postoperative recovery parameters, pain scores, complications, and the Oswestry Disability Index (ODI), were recorded.</p><p><strong>Results: </strong>The study enrolled 114 frail patients, equally distributed into ERAS and non-ERAS cohorts. ERAS intervention significantly reduced the length of hospital stay (6.95 ± 2.74 days vs. 8.72 ± 4.54 days, p = 0.024) and blood transfusion rates (19.3% vs. 49.1%, p = 0.001). Time to remove the drain and indwelling catheter showed no statistically significant difference. Postoperative VAS scores and Oswestry Disability Index (ODI) scores at 6-week, 6-month, and 12-month follow-up intervals were comparable between groups. There was no significant difference in the incidence of major or minor complications between the two groups.</p><p><strong>Conclusions: </strong>Our study suggests that applying an ERAS pathway to frail individuals undergoing short-segment lumbar fusion can shorten hospital stay and lower transfusion rates, while not increasing complications, reoperations, or readmissions.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261442735"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sleep Quality and Geriatric Hip Fracture: A Prospective Comparative Study.","authors":"Erkan Akgun, Kemal Sibar, Huseyin Emre Tepedelenlioglu, Yavuz Emre Aktasoglu, Halil Gok, Aytek Huseyin Celiksoz, Abdulsamet Emet","doi":"10.1177/21514593261441091","DOIUrl":"10.1177/21514593261441091","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the association between sleep disturbance and geriatric hip fracture.</p><p><strong>Methods: </strong>Between January 2023 and August 2024, 90 patients admitted to the Adult Emergency Clinic with the diagnosis of hip fracture were included in the study. In addition, a control group consisted of 90 patients, aged ≥65 years, and undergoing elective orthopedic surgery without prior hip fracture. The Pittsburg Sleep Quality Index (PSQI) test, Bone Mineral Densitometry and Vitamin D and Calcium levels were examined and noted in the inpatient service for both groups of patients two days after surgery.</p><p><strong>Results: </strong>A total of 180 patients were included. The fracture group demonstrated higher PSQI scores compared with the control group (6.74 ± 4.02 vs 5.23 ± 3.06, p=0.005). Poor sleep quality (PSQI >5) was more frequent in the fracture group (73.3% vs 33.3%, p<0.001). Serum calcium levels were lower in the fracture group (p<0.001), while vitamin D and DEXA scores were not significantly different (p=0.796 and p=0.119, respectively). Within the fracture cohort, poorer sleep quality was associated with older age and female sex.</p><p><strong>Conclusion: </strong>Geriatric hip fracture patients demonstrated poorer sleep quality compared with elective surgical control patients. Screening for sleep problems could help identify high-risk geriatric individuals who may benefit from comprehensive fall-prevention strategies.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261441091"},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Upper-Extremity Fractures in Older Adults: Predictors of 5-Year Mortality.","authors":"Emre Öztürk, Elyesa Ergen, Mohammad Yaman Hanano, Ender Gümüşoğlu, Zeynel Mert Asfuroğlu","doi":"10.1177/21514593261438016","DOIUrl":"10.1177/21514593261438016","url":null,"abstract":"<p><strong>Background: </strong>To estimate 5-year mortality after major upper-extremity fractures in adults aged ≥65 years and to identify clinical and fracture-related factors associated with mortality.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study of adults aged ≥65 years who presented between 2014 and 2020 with a suspected major upper-extremity fracture. Fracture diagnoses were confirmed on archived radiographs and analyzed by index diagnosis and by anatomic region. Candidate factors included age, sex, comorbidity burden (age-adjusted Charlson Comorbidity Index [aCCI] categories), presence of concomitant fractures outside the upper extremity, injury mechanism (low- vs high-energy), upper-extremity fracture multiplicity, and treatment type (operative vs nonoperative). Five-year mortality was the primary outcome.</p><p><strong>Results: </strong>A total of 1,240 patients were included (median age 73 years; 67.3% female) with a median follow-up of 6.0 years. Five-year mortality was 28.2% (95% CI 25.7-30.8). Mortality differed by fracture location, lowest after wrist-region fractures (especially distal radius) and highest after arm-region fractures (especially humeral shaft). Mortality increased with age and was higher in men. Concomitant fractures outside the upper extremity and greater comorbidity burden were associated with higher mortality, with a stepwise gradient across aCCI categories (2-3, 4-5, and ≥6). Injury mechanism, upper-extremity fracture multiplicity, and treatment type were not significantly associated with 5-year mortality.</p><p><strong>Conclusions: </strong>In older adults with major upper-extremity fractures, long-term mortality is substantial and is most strongly associated with baseline vulnerability-especially comorbidity burden-the presence of concomitant fractures outside the upper extremity, and fracture location. Larger multicenter studies incorporating standardized frailty and functional measures are needed to confirm these associations and to inform care pathways for high-risk patients.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261438016"},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Clock: Understanding Delays in Hip Fracture Surgery.","authors":"Ella Davies, Benjamin H L Harris, Michael B Fertleman, Louis J Koizia","doi":"10.1177/21514593261424772","DOIUrl":"10.1177/21514593261424772","url":null,"abstract":"","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261424772"},"PeriodicalIF":1.8,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Fall Timing and Location With Clinical Characteristics in Geriatric Hip Fracture Patients: A Cross-Sectional Study.","authors":"Chun-Ching Chen, Chien-Hua Chen, Yi-Jie Kuo, Tai-Yuan Chuang, Yu-Pin Chen","doi":"10.1177/21514593251407945","DOIUrl":"10.1177/21514593251407945","url":null,"abstract":"<p><strong>Introduction: </strong>Falls can be detrimental for older adults, causing hip fracture that result in disability and increased risk of mortality. This study aimed to investigate the temporal distribution of falls among the geriatric patients with hip fractures and compare the characteristics of falls occurring at different times and locations.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 801 older adults with hip fractures from falls. We collected data on fall timing (day vs night), location (indoor vs outdoor), and patient characteristics, including demographics, handgrip strength, BMI, and the Charlson Comorbidity Index (CCI). The primary analysis investigated the association between these clinical characteristics and the specific circumstances of the fall.</p><p><strong>Results: </strong>This study encompassed 801 hip fracture patients, with 560 women (70%) and 241 men (30%), and a median age of 81 years. Among these patients, 546 (68.3%) experienced falls during the daytime, while 255 (31.7%) fell at night. Furthermore, 577 (74.9%) hip fractures occurred indoors, with 193 (25.1%) falls taking place outdoors. The analysis revealed that patients with lower handgrip strength and BMI were significantly more susceptible to nighttime falls compared to daytime falls. Furthermore, patients who fell indoors exhibited notably higher CCI scores, along with lower BMI, handgrip strength, and pre-fracture ADL, in comparison to those who fell outdoors.</p><p><strong>Conclusions: </strong>Our findings indicate that falls during the daytime were more prevalent among geriatric hip fracture patients in Taiwan compared to nighttime falls. Moreover, we observed that more frail patients were relatively susceptible to falling indoors and at night, emphasizing the potential clinical value for clinicians to take proactive measures in fall prevention.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593251407945"},"PeriodicalIF":1.6,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Spinopelvic Parameters and Hip Fracture Types.","authors":"Suleyman Cakirturk, Ferid Samedov, Haci Mustafa Ozdemir, Samet Erinc, Muharrem Kanar, Yusuf Yahsi","doi":"10.1177/21514593261425087","DOIUrl":"10.1177/21514593261425087","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to investigate whether or not spinopelvic parameters alone affect the mechanism of formation and type of hip fracture. A secondary aim was to examine the impact on the formation mechanism of many factors that have been previously determined in the epidemiology of hip fractures.</p><p><strong>Material and method: </strong>The data of 200 patients who presented because of a hip fracture were retrospectively examined. The data included age, gender, body mass index, affected side and Singh Index (SI), and the measurements taken on radiographs of pelvic incidence, pelvic tilt, sacral slope, and lumbar lordosis values. The hip fractures were categorised into two groups: femoral neck and pertrochanteric.</p><p><strong>Results: </strong>The 100 patients in Group 1 (femoral neck) comprised 64 females and 36 males with a mean age of 75.4 ± 10.9 years, and the 100 patients in Group 2 (pertrochanteric) comprised 70 females and 30 males with a mean age of 77.6 ± 11.1 years. In Group 1, the mean values measured were pelvic incidence: 49.9 ± 11.6, pelvic tilt: 12.25 ± 7.68, sacral slope: 37.7 ± 10.1, and lumbar lordosis: 49.6 ± 13.2. In Group 2, these values were pelvic incidence: 57.2 ± 14.2, pelvic tilt: 15.62 ± 9.72, sacral slope: 41.6 ± 11.5, and lumbar lordosis: 55 ± 14.5. These values were statistically significantly higher in the pertrochanteric group than in the femoral neck group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrated that pelvic incidence and related spinopelvic parameters are associated with hip fracture morphology. Patients with pertrochanteric fractures had significantly higher pelvic parameter values compared with those with femoral neck fractures, suggesting that increased pelvic incidence may predispose to pertrochanteric fractures.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261425087"},"PeriodicalIF":1.6,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Dementia on Perioperative Complications in Elderly Patients Undergoing Total Knee Arthroplasty: A Retrospective National Inpatient Sample Database Study.","authors":"Yusong Zhang, Linjia Li, Yuanwei Wu, Jian Wang, Yuxin Zhong, Qinfeng Yang, Jiwei Luo","doi":"10.1177/21514593261419684","DOIUrl":"10.1177/21514593261419684","url":null,"abstract":"<p><strong>Background: </strong>Dementia is widely recognized as a factor that influences the outcomes of total knee arthroplasty (TKA). However, recent studies have not fully elucidated the effects of dementia on perioperative medical and surgical complications, as well as in-hospital resource utilization. The objective of this study is to evaluate the specific impact of dementia on perioperative outcomes in elderly patients undergoing TKA.</p><p><strong>Methods: </strong>Data on elderly patients undergoing TKA were extracted from the National Inpatient Sample database (2010-2019). Patients were categorized into a dementia group and a non-dementia group. Propensity score matching (PSM) was employed to control for differences in demographics, hospital characteristics, and comorbidities. Multivariate logistic regressions were conducted to evaluate perioperative outcomes.</p><p><strong>Results: </strong>From 2010 to 2019, a group of 344,200 patients undergoing TKA was identified, among whom 6761 individuals (2.0%) were diagnosed with dementia. Following PSM, dementia remained an independent predictor for several perioperative outcomes, including urinary tract infection (aOR = 2.001, 95%CI = 1.561-2.564, <i>P</i> < 0.0001), pneumonia (aOR = 2.043, 95%CI = 1.244-3.355, <i>P</i> = 0.005), postoperative delirium (aOR = 5.854, 95%CI = 4.418-7.758, <i>P</i> < 0.0001), acute hemorrhagic anemia (aOR = 1.229, 95%CI = 1.128-1.340, <i>P</i> < 0.0001), prolonged hospital stay (aOR = 1.966, 95%CI = 1.785-2.165, <i>P</i> < 0.0001), and increased total healthcare charges (aOR = 1.122, 95%CI = 1.037-1.215, <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>Dementia is independently associated with an increased risk of perioperative complications after TKA, underscoring the importance of tailored perioperative care for elderly patients with dementia.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261419684"},"PeriodicalIF":1.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}