Risk for hip fracture before and after total knee replacement in Sweden

Abstract

We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.

"Epidemiological, Characteristics and Outcomes of Hip Fracture Among Patients in Baghdad"

“…Partial hip replacements are the main operation procedure were using for it and shows in 45.1%. Compared with a study done it in Sweden [15], the hip replacements were the fundamental procedure which is using for it especially among elderly. The main causes of hip fractures was tumbling and fall from the height and shows in 38.5% compared with other study in New Zealand (10), they reported the majority were fall and exposed to traffic accident.…”

“…The risk of fracture recurrence persists in ten years, which illustrates the importance of treating primary fractures quickly and effectively [14]. Treatment options include surgery, and statistics indicated that more than three-quarters of people with a broken hip undergo surgery, often a joint replacement [15]. Surgical intervention usually occurs to 48 hours [16].…”

Comorbid Factors and Selection for Same-Day Total Joint Arthroplasty

“…Osteoporosis can increase the risk of periprosthetic fracture. Studies have also shown an increased risk of hip fracture 1 to 5 years after THA and TKA [32,39]. Studies looking at periprosthetic fracture during TKA have shown an incidence of 0.3% to 2.5% [9,33].…”

Kas iskelet sisteminin yaşlanması ve yaşlılarda kalça anatomisinde değişiklikler

“…OA ve kalça kırığı benzer popülasyonları etkileyebilmesine ve karşılaştırılabilir fonksiyonel bozukluklara neden olabilmesine rağmen, yapılan çalışmalarda kalça kırığı olan hastalarda osteoartritin daha az olduğunu göstermektedir. [22][23][24] Bununla birlikte, OA kalça kırığı riskini artırabilecek veya azaltabilecek bir dizi faktörle ilişkili olduğundan, bu iddianın geçerliliği belirsizdir. [24] Örneğin, bir kalça kırığı oluşma riski, belirli bir yaş kategorisinde daha düşük kemik mineral yoğunluğuna sahip olanlar arasında daha yüksektir.…”