Objective: To assess the reliability, durability, and safety of primary and revision total hip arthroplasty (THA) in patients 90 years of age and older. Patients and Methods: Between 1970 and 1997, 66 THAs, 48 primary and 18 revision, were done for 65 patients aged 90 to 104 years (mean, 92 years). The Harris hip score was used to assess hip pain and function. Results: Patients were evaluated for pain, function, and satisfaction at a mean of 3.2 years after the THA. The Harris hip scores improved significantly (P=.004) for both primary and revision groups: from preoperative mean scores of 39 and 45 points to follow-up scores of 80 and 75 points, respectively. Two patients died in the early postoperative period of causes related to the operation. Thirtyseven other patients were dead at last follow-up and had lived a mean ± SD of 6±2.2 years after the primary THA and 4.2±2.8 years after the revision THA. No hips required subsequent revision. Conclusion: Total hip replacement was reliable, durable, and safe in this study group. Primary care physicians and surgeons should be aware that both primary and revision total hip replacement can be done safely and effectively in patients aged 90 years and older and can result in years of relief of pain and functional improvement.
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