Retrospective Population-Based Cohort Study of Incidence, Complications, and Survival of 202 Operatively Treated Periprosthetic Femoral Fractures

J Arthroplasty. 2021 Jul;36(7):2591-2596. doi: 10.1016/j.arth.2021.02.060. Epub 2021 Mar 1.

Abstract

Background: The aim of this study is to investigate the population and primary total hip arthroplasty (THA)-based incidences, fracture types, complications, and survival of operatively treated periprosthetic femoral fracture (PFF).

Methods: This retrospective study reviewed 202 cases of operatively treated PFFs in a study period from January 2004 to December 2016. The Vancouver classification was used to classify PFFs.

Results: The incidence of PFF related to 1000 primary THAs per year was 2.7 (standard deviation 1.0, range 0.9-4.5) at a defined hospital district area during the study period. The mean population-based incidence of operatively treated PFFs raised from 1.6 to 4.5 per 100,000 person-years during the study period. The B1-type fracture was the most common fracture type in 71 of 202 (35%) of these PFFs. The cumulative incidence of re-revision was 10.9% at 1 year and 15.6% at 15 years (95% confidence interval [CI] 10.9-21.0). The cumulative incidence for other major complications was 6.4% at 1 year and 9.9% at 15 years (95% CI 5.9-15.0). The cumulative incidence of death after PFF was 7.4% at 1 year and 56.3% at 15 years (95% CI 41.3-68.8) during the follow-up time from January 1, 2004 to December 31, 2019.

Conclusion: This country-specific study showed a 3-fold increasing trend in the incidence of operatively treated PFFs from 2004 to 2016 per 1000 THAs. The Vancouver type B1 fracture was the most common type. A high number of complications were associated with PFFs and 7.4% of the patients had died within 1 year after PFF surgery.

Keywords: complications; mortality; outcome; periprosthetic femoral fractures; revision arthroplasty; survival.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Cohort Studies
  • Femoral Fractures* / epidemiology
  • Femoral Fractures* / surgery
  • Humans
  • Incidence
  • Periprosthetic Fractures* / epidemiology
  • Periprosthetic Fractures* / surgery
  • Reoperation
  • Retrospective Studies