Risk factors for periprosthetic femoral fractures around total hip arthroplasty: a systematic review and meta-analysis.
periprosthetic femoral fracture
primary hip arthroplasty
revision hip arthroplasty
risk factor
total hip arthroplasty
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
16
03
2019
revised:
09
08
2019
accepted:
19
08
2019
pubmed:
17
10
2019
medline:
15
5
2021
entrez:
17
10
2019
Statut:
ppublish
Résumé
Periprosthetic fractures are becoming increasingly common, often leading to poor patient outcomes. The aim of this study was to identify risk factors associated with periprosthetic femoral fractures (PPFFx). Two independent reviewers conducted a systematic review of the databases MEDLINE, Embase and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the earliest available date to December 2017. We included all clinical articles reporting more than 100 post-operative PPFFx around total hip arthroplasty (THA). Outcomes included demographics, fracture type, risk factors and time to fracture. A total of 12 868 PPFFx were reported across 18 eligible studies; 64% occurred following primary THA and 36% occurred after revision THA, and 66% of all fractures were in females. Vancouver B2 fractures were the most common type (39%). We found the odds of sustaining a PPFFx is significantly lower after a primary THA compared to revision THA (odds ratio 0.31, 95% confidence interval 0.24-0.40, P < 0.00001). The incidence of PPFFx is 2.96 per 1000 person-years following primary THA compared to 9.08 per 1000 person-years following revision THA (odds ratio 0.33, 95% confidence interval 0.27-0.40). The time to fracture was 6.03 years following primary THA and 4.08 years following revision THA. Gender and cementation did not significantly affect the odds of fracture. The odds of sustaining a PPFFx following revision THA is three times greater compared to primary THA. Other risk factors including gender and cementation did not affect the odds of fracture.
Sections du résumé
BACKGROUND
Periprosthetic fractures are becoming increasingly common, often leading to poor patient outcomes. The aim of this study was to identify risk factors associated with periprosthetic femoral fractures (PPFFx).
METHODS
Two independent reviewers conducted a systematic review of the databases MEDLINE, Embase and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the earliest available date to December 2017. We included all clinical articles reporting more than 100 post-operative PPFFx around total hip arthroplasty (THA). Outcomes included demographics, fracture type, risk factors and time to fracture.
RESULTS
A total of 12 868 PPFFx were reported across 18 eligible studies; 64% occurred following primary THA and 36% occurred after revision THA, and 66% of all fractures were in females. Vancouver B2 fractures were the most common type (39%). We found the odds of sustaining a PPFFx is significantly lower after a primary THA compared to revision THA (odds ratio 0.31, 95% confidence interval 0.24-0.40, P < 0.00001). The incidence of PPFFx is 2.96 per 1000 person-years following primary THA compared to 9.08 per 1000 person-years following revision THA (odds ratio 0.33, 95% confidence interval 0.27-0.40). The time to fracture was 6.03 years following primary THA and 4.08 years following revision THA. Gender and cementation did not significantly affect the odds of fracture.
CONCLUSION
The odds of sustaining a PPFFx following revision THA is three times greater compared to primary THA. Other risk factors including gender and cementation did not affect the odds of fracture.
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-447Informations de copyright
© 2019 Royal Australasian College of Surgeons.
Références
Marsland D, Mears SC. A review of periprosthetic femoral fractures associated with total hip arthroplasty. Geriatr. Orthop. Surg. Rehabil. 2012; 3: 107-20.
New Zealand Orthopaedic Association. The New Zealand Joint Registry, Nineteenth Year Report. Wellington: New Zealand Orthopaedic Association, 2018.
Australian Orthopaedic Association. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Annual Report: Hip, Knee and Shoulder Arthroplasty. Adelaide: Australian Orthopaedic Association, 2018.
Drew JM, Griffin WL, Odum SM, Van Doren B, Weston BT, Stryker LS. Survivorship after periprosthetic femur fracture: factors affecting outcome. J. Arthroplasty 2016; 31: 1283-8.
Shields E, Behrend C, Bair J, Cram P, Kates S. Mortality and financial burden of periprosthetic fractures of the femur. Geriatr. Orthop. Surg. Rehabil. 2014; 5: 147-53.
Lindahl H, Garellick G, Regner H, Herberts P, Malchau H. Three hundred and twenty-one periprosthetic femoral fractures. J. Bone Joint Surg. Am. 2006; 88: 1215-22.
Fuchtmeier B, Galler M, Muller F. Mid-term results of 121 periprosthetic femoral fractures: increased failure and mortality within but not after one postoperative year. J. Arthroplasty 2015; 30: 669-74.
Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA. Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J. Bone Joint Surg. Am. 2008; 90: 2000-12.
Abdel MP, Houdek MT, Watts CD, Lewallen DG, Berry DJ. Epidemiology of periprosthetic femoral fractures in 5417 revision total hip arthroplasties: a 40-year experience. Bone Joint J. 2016; 98-B: 468-74.
Brady OH, Garbuz DS, Masri BA, Duncan CP. The reliability and validity of the Vancouver classification of femoral fractures after hip replacement. J. Arthroplasty 2000; 15: 59-62.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann. Intern. Med. 2009; 151: 264-9 W64.
The Joanna Briggs Institute. Critical Appraisal Tools. Adelaide: The University of Adelaide, 2017. [Cited 1 July 2019.] Available from URL: http://joannabriggs.org/research/critical-appraisal-tools.html.
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J. Surg. 2003; 73: 712-6.
The Cochrane Collaboration. Review Manager (RevMan). Version 5.3 ed. Copenhagen: The Nordic Cochrane Centre, 2014.
Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J. Bone Joint Surg. Br. 2011; 93: 96-101.
Trousdale WH, Abdel MP, Viste A, Trousdale RT, Callaghan JJ, Berry DJ. Seasonality of periprosthetic femur fractures in 12,700 primary and revision total hip arthroplasties. J. Arthroplasty 2017; 32: 2000-4.
Cox JS, Kowalik TD, Gehling HA, DeHart ML, Duwelius PJ, Mirza AJ. Frequency and treatment trends for periprosthetic fractures about total hip arthroplasty in the United States. J. Arthroplasty 2016; 31(9 Suppl.): 115-20.
Gitajn IL, Heng M, Weaver MJ et al. Mortality following surgical management of Vancouver B periprosthetic fractures. J. Orthop. Trauma 2017; 31: 9-14.
Katz JN, Wright EA, Polaris JJ, Harris MB, Losina E. Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskelet. Disord. 2014; 15: 168.
Palan J, Smith MC, Gregg P et al. The influence of cemented femoral stem choice on the incidence of revision for periprosthetic fracture after primary total hip arthroplasty: an analysis of national joint registry data. Bone Joint J. 2016; 98-B: 1347-54.
Park KJ, Menendez ME, Barnes CL. Perioperative periprosthetic fractures associated with primary total hip arthroplasty. J. Arthroplasty 2017; 32: 992-5.
Pavlou G, Panteliadis P, Macdonald D et al. A review of 202 periprosthetic fractures - stem revision and allograft improves outcome for type B fractures. Hip Int. 2011; 21: 21-9.
Sellan ME, Lanting BA, Schemitsch EH, MacDonald SJ, Vasarhelyi EM, Howard JL. Does time to surgery affect outcomes for periprosthetic femur fractures? J. Arthroplasty 2018; 33: 878-81.
Singh JA, Jensen MR, Harmsen SW, Lewallen DG. Are gender, comorbidity, and obesity risk factors for postoperative periprosthetic fractures after primary total hip arthroplasty? J. Arthroplasty 2013; 28: 126-31.e2.
Singh JA, Jensen MR, Lewallen DG. Patient factors predict periprosthetic fractures after revision total hip arthroplasty. J. Arthroplasty 2012; 27: 1507-12.
Abdel MP, Watts CD, Houdek MT, Lewallen DG, Berry DJ. Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience. Bone Joint J. 2016; 98-B: 461-7.
Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J. Arthroplasty 2005; 20: 857-65.
Mahomed NN, Barrett JA, Katz JN et al. Rates and outcomes of primary and revision total hip replacement in the United States medicare population. J. Bone Joint Surg. Am. 2003; 85-A: 27-32.
Sakellariou VI, Babis GC. Management bone loss of the proximal femur in revision hip arthroplasty: update on reconstructive options. World J. Orthop. 2014; 5: 614-22.
Panegrossi G, Ceretti M, Papalia M, Casella F, Favetti F, Falez F. Bone loss management in total knee revision surgery. Int. Orthop. 2014; 38: 419-27.
Franklin J, Malchau H. Risk factors for periprosthetic femoral fracture. Injury 2007; 38: 655-60.
Alswat KA. Gender disparities in osteoporosis. J. Clin. Med. Res. 2017; 9: 382-7.
Cawthon PM. Gender differences in osteoporosis and fractures. Clin. Orthop. Relat. Res. 2011; 469: 1900-5.
Thomsen MN, Jakubowitz E, Seeger JB, Lee C, Kretzer JP, Clarius M. Fracture load for periprosthetic femoral fractures in cemented versus uncemented hip stems: an experimental in vitro study. Orthopedics 2008; 31: 653.
Wyatt M, Hooper G, Frampton C, Rothwell A. Survival outcomes of cemented compared to uncemented stems in primary total hip replacement. World J. Orthop. 2014; 5: 591-6.
Hailer NP, Garellick G, Karrholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register. Acta Orthop. 2010; 81: 34-41.
Moerman S, Mathijssen N, Niesten D et al. More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up. BMC Musculoskelet. Disord. 2017; 18: 169.
Rupprecht M, Sellenschloh K, Grossterlinden L et al. Biomechanical evaluation for mechanisms of periprosthetic femoral fractures. J. Trauma 2011; 70: E62-6.
Boylan MR, Riesgo AM, Paulino CB, Slover JD, Zuckerman JD, Egol KA. Mortality following periprosthetic proximal femoral fractures versus native hip fractures. J. Bone Joint Surg. Am. 2018; 100: 578-85.
Khan T, Grindlay D, Ollivere BJ, Scammell BE, Manktelow AR, Pearson RG. A systematic review of Vancouver B2 and B3 periprosthetic femoral fractures. Bone Joint J. 2017; 99-B(4 Suppl. B): 17-25.
Bergh C, Fenstad AM, Furnes O et al. Increased risk of revision in patients with non-traumatic femoral head necrosis. Acta Orthop. 2014; 85: 11-7.
Thien TM, Chatziagorou G, Garellick G et al. Periprosthetic femoral fracture within two years after total hip replacement: analysis of 437,629 operations in the nordic arthroplasty register association database. J. Bone Joint Surg. Am. 2014; 96: e167.