High mortality rate following periprosthetic femoral fractures after total hip arthroplasty. A multicenter retrospective study

Moreta, Jesús; Uriarte, Iker; Bidea, Iñigo; Foruria, X.; Legarreta, María José; Etxebarría-Foronda, I.

doi:10.1016/j.injury.2021.01.035

Cited by 14 publications

(9 citation statements)

References 21 publications

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“…Considering the Vancouver classification system, the majority of the patients in the presented study had a Vancouver B fracture and the time from primary arthroplasty to PPF was 8 years. These results are comparable to other current studies of PPF around the hip [ 3 , 5 , 24 , 26 ]. More than 50% of patients had a cementless femoral component, which potentially contributes a PPF independent of age and gender [ 27 , 28 ].…”

Section: Discussionsupporting

confidence: 92%

“…Moreta et al and Füchtmeier et al also reported a similar risk profile for patients with PPF [ 24 , 25 ]. This is an important factor that has to be considered to guide treatment since these studies showed an increased 30-day as well as 1-year mortality with increasing age and higher ASA score in patients with PPF [ 22 , 24 , 25 ]. As comorbidities seem to be an important variable regarding the choice for the best treatment in PPF, Patsiogiannis et al proposed a new treatment algorithm for PPFs also taking into consideration the patient`s comorbidities [ 10 ].…”

Section: Discussionmentioning

confidence: 82%

“…Finlayson et al analyzed the outcome following proximal periprosthetic femur fractures and reported in the majority of the patients an ASA score ≥ III [22]. Moreta et al and Füchtmeier et al also reported a similar risk profile for patients with PPF [24,25]. This is an important factor that has to be considered to guide treatment since these studies showed an increased 30-day as well as 1-year mortality with increasing age and higher ASA score in patients with PPF [22,24,25].…”

Section: Discussionmentioning

confidence: 98%

“…This is a typical age and gender distribution and also present in other comparable studies [ 2 , 20 – 22 ]. The female preponderance might be explained by the higher lifespan and higher prevalence for osteoporosis [ 23 , 24 ], contributing to a greater risk for a periprosthetic fracture of the hip [ 10 ]. More than three quarters of patients had an ASA score ≥ 3, representing a population with severe primary disease and limited overall health.…”

Section: Discussionmentioning

confidence: 99%

“…The 1-year mortality after periprosthetic femoral fracture is similar to that after hip fracture, ranging from 7 to 22% [ 3 , 4 , 6 , 24 ]. In the presented study, the mortality rate of 14% is comparable, taking into consideration that the follow-up period included 2 years.…”

Section: Discussionmentioning

confidence: 99%

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Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Pflüger

Bolierakis

Wurm

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Effective therapy of periprosthetic femur fractures of the hip (PPF) are challenging due to patients’ frailty and complexity of fracture patterns. The aim of this cohort study was to analyze the radiological and functional outcome following PPF. Methods A retrospective, multicenter study in the period 2009–2019 of patients with PPF at two level I trauma centers in Germany was performed. PPF were classified according to the Vancouver classification system. Demographic data, American Society of Anesthesiologists (ASA) classification, type of surgery, complications, and reoperation rate were obtained from patient records. The functional outcome was assessed by the modified Harris-Hip Score (mHHS), general health using the EQ-5D, and radiological outcome by Beals & Tower (B&T) criteria. Results A total of 129 patients with a mean age of 79 years (range 43–102) were included. 70% of all patients were female and 68% of the patients had an ASA score ≥ 3. 20 patients suffered from a Vancouver A, 90 from a Vancouver B and 19 from a Vancouver C fracture. 14% of the patients died within the first 2 years after surgery. The reoperation rate after open reduction and internal fixation (ORIF) (n = 60) was 8% and after revision arthroplasty (RA) (n = 47) 30% (OR 3.4, 95% CI [1.21–10.2]). Mean mHHS (n = 32) was 53 ± 19.4 and EQ-VAS was 50 ± 24.6. According to B&T criteria, 82% of patients treated with ORIF (n = 17) and 62% after RA (n = 13) showed an excellent outcome. Conclusion Patients with a PPF of the hip are elderly and at increased operative risk. In cases with a stable prosthesis, ORIF provides good radiological outcome with low reoperation rates. In case of RA, the risk for revision surgery is higher.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Pflüger

Bolierakis

Wurm

et al. 2021

Eur J Trauma Emerg Surg

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Unveiling additively manufactured cellular structures in hip implants: a comprehensive review

Dias,

da Silva,

Gasik

et al. 2023

Int J Adv Manuf Technol

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The prospect of improved quality of life and the increasingly younger age of patients benefiting from Total Hip Arthroplasty will soon lead to the landmark of 10 million interventions per year worldwide. More than 10% of these procedures lead to significant bone resorption, increasing the need for revision surgeries. Current research focuses on the development of hip implant designs to achieve a stiffness profile closer to the natural bone. Additive Manufacturing has emerged as a viable solution by offering promising results in the fabrication of implant architectures based on metallic cellular structures that have demonstrated their capacity to replicate bone behavior mechanically and biologically. Aiming to offer an up-to-date overview of titanium cellular structures in hip implants, for both acetabular and femoral components, produced by Additive Manufacturing, including its design intricacies and performance, this comprehensive review meticulously examines the historical development of hip implants, encompassing commercial solutions and innovative attempts. A broad view of the practical applications and transformative potential of hip implants incorporating cellular structures is presented, aiming to outline opportunities for innovation.

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Periprocedural clinical outcomes of revision hip arthroplasty: a multi-centric comparison of current strategies based on the NSQIP

Bulut,

Maestre,

Tomey

2024

Arch Orthop Trauma Surg

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High mortality rate following periprosthetic femoral fractures after total hip arthroplasty. A multicenter retrospective study

Cited by 14 publications

References 21 publications

Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Revision rate is higher in patients with periprosthetic femur fractures following revision arthroplasty in comparison with ORIF following our algorithm: a two-center 1 analysis of 129 patients

Unveiling additively manufactured cellular structures in hip implants: a comprehensive review

Periprocedural clinical outcomes of revision hip arthroplasty: a multi-centric comparison of current strategies based on the NSQIP

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