Christos Bissias1, Angelos Kaspiris2, Athanasios Kalogeropoulos3, Konstantinos Papoutsis4, Nikolaos Natsioulas4, Konstantinos Barbagiannis4, Panayiotis J Papagelopoulos5, Olga D Savvidou5. 1. Department of Orthopaedic Surgery, Naval Hospital of Athens, Deinokratous 70, 115 21, Athens, Greece. chrisbis@hotmail.com. 2. Laboratory of Molecular Pharmacology/Division for Orthopaedic Research, School of Health Sciences, University of Patras, 26504, Patras, Greece. 3. Sonnenhof Spital, Bern, Switzerland. 4. Department of Orthopaedic Surgery, Naval Hospital of Athens, Deinokratous 70, 115 21, Athens, Greece. 5. 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University General Hospital, 124 62, Athens, Greece.
Abstract
OBJECTIVES: The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. METHODS: A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words "risk factor," "periprosthetic fracture," and "hip replacement or arthroplasty." Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. RESULTS: Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (- 57%), cement application (- 59%), and insertion of Biomet (- 68%) or Thompson's prosthesis (- 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. CONCLUSION: This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.
OBJECTIVES: The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. METHODS: A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words "risk factor," "periprosthetic fracture," and "hip replacement or arthroplasty." Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. RESULTS: Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (- 57%), cement application (- 59%), and insertion of Biomet (- 68%) or Thompson's prosthesis (- 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. CONCLUSION: This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.
Entities:
Keywords:
Hip arthroplasty; Periprosthetic fractures; Risk factors
Authors: Truike M Thien; Georgios Chatziagorou; Göran Garellick; Ove Furnes; Leif I Havelin; Keijo Mäkelä; Søren Overgaard; Alma Pedersen; Antti Eskelinen; Pekka Pulkkinen; Johan Kärrholm Journal: J Bone Joint Surg Am Date: 2014-10-01 Impact factor: 5.284
Authors: Hilal Maradit Kremers; Dirk R Larson; Cynthia S Crowson; Walter K Kremers; Raynard E Washington; Claudia A Steiner; William A Jiranek; Daniel J Berry Journal: J Bone Joint Surg Am Date: 2015-09-02 Impact factor: 5.284