Article ; Online: Perioperative Periprosthetic Femur Fractures are Strongly Correlated With Fixation Method: an Analysis From the American Joint Replacement Registry.
2019 Volume 34, Issue 7S, Page(s) S352–S354
Abstract: Background: Perioperative periprosthetic femur fractures (PPFx) after total hip arthroplasty (THA) remain a leading cause of early stem failure and revision and are associated with high rates of morbidity and mortality. American Joint Replacement ... ...
| Abstract | Background: Perioperative periprosthetic femur fractures (PPFx) after total hip arthroplasty (THA) remain a leading cause of early stem failure and revision and are associated with high rates of morbidity and mortality. American Joint Replacement Registry (AJRR) data have been analyzed to determine the relationship of femoral stem fixation to PPFx revision. Methods: All early (≤3 months from index arthroplasty) linked primary and revision hip arthroplasties reported to the AJRR between 2012 and 2017 were analyzed. We evaluated patient demographics, arthroplasty type (hemiarthroplasty vs THA), and stem fixation. Results: A total of 10,277 linked revisions were reported to the AJRR during 2012-2017. Early PPFx requiring revision occurred in 628 patients (6.1%) due to osteoarthritis (82.4%), femoral neck fracture (12.1%), and other causes (15.6%). Five hundred twenty-nine patients (84%) were treated with THA and 99 patients with hemiarthroplasty (16%). Females (70%) have a higher prevalence of revisions. Fifty-eight percent of patients were ≥70 years of age, and 20% were ≥80 years of age. Patients with cementless stems were 2.6 times (account 94.9% of the fractures, 95% confidence interval 0.59-11.1) more likely to undergo early revision for PPFx than those with cemented fixation, although not statistically significant with its sample size. Conclusion: Mirroring other studies and national registries, there was an association between cementless fixation and PPFx in AJRR. Nevertheless, AJRR data demonstrate a trend of increasing utilization of cementless femoral fixation for THA and hemiarthroplasty, with cementless fixation accounting for 93% of THA stems with early periprosthetic fracture. Additional analysis is needed to better understand this phenomenon, especially in the elderly. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip/adverse effects ; Female ; Femoral Fractures/complications ; Femoral Fractures/surgery ; Femoral Neck Fractures/surgery ; Femur/surgery ; Fracture Fixation/adverse effects ; Fracture Fixation/methods ; Hemiarthroplasty/adverse effects ; Hip Prosthesis/adverse effects ; Humans ; Male ; Middle Aged ; Periprosthetic Fractures/surgery ; Prosthesis Design ; Registries ; Reoperation/statistics & numerical data ; Risk Factors ; United States |
| Language | English |
| Publishing date | 2019-02-10 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 632770-9 |
| ISSN | 1532-8406 ; 0883-5403 |
| ISSN (online) | 1532-8406 |
| ISSN | 0883-5403 |
| DOI | 10.1016/j.arth.2019.02.004 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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