Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk?
Abstract. Objectives:. To compare mortality rates between patients treated surgically for periprosthetic fractures (PPF) after total hip arthroplasty (THA), total knee arthroplasty (TKA), peri-implant (PI), and interprosthetic (IP) fractures while identifying risk factors associated with mortality f...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-03-01
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| Series: | OTA International |
| Online Access: | http://journals.lww.com/10.1097/OI9.0000000000000322 |
| _version_ | 1797243124255293440 |
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| author | Jay K. Shah, DO Laith Z. Abwini, MS Alex Tang, MD Jason I. Yang, BS David M. Keller, DO Luke G. Menken, DO Frank A. Liporace, MD Richard S. Yoon, MD |
| author_facet | Jay K. Shah, DO Laith Z. Abwini, MS Alex Tang, MD Jason I. Yang, BS David M. Keller, DO Luke G. Menken, DO Frank A. Liporace, MD Richard S. Yoon, MD |
| author_sort | Jay K. Shah, DO |
| collection | DOAJ |
| description | Abstract. Objectives:. To compare mortality rates between patients treated surgically for periprosthetic fractures (PPF) after total hip arthroplasty (THA), total knee arthroplasty (TKA), peri-implant (PI), and interprosthetic (IP) fractures while identifying risk factors associated with mortality following PPF.
Design:. Retrospective.
Setting:. Single, Level II Trauma Center.
Patients/Participants:. A retrospective review was conducted of 129 consecutive patients treated surgically for fractures around a pre-existing prosthesis or implant from 2013 to 2020. Patients were separated into 4 comparison groups: THA, TKA, PI, and IP fractures.
Intervention:. Revision implant or arthroplasty, open reduction and internal fixation (ORIF), intramedullary nailing (IMN), percutaneous screws, or a combination of techniques.
Main Outcome Measurements:. Primary outcome measures include mortality rates of different types of PPF, PI, and IP fractures at 1-month, 3-month, 6-month, 1-year, and 2-year postoperative. We analyzed risk factors associated with mortality aimed to determine whether treatment type affects mortality.
Results:. One hundred twenty-nine patients were included for final analysis. Average follow-up was similar between all groups. The overall 1-year mortality rate was 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%). There were no differences in mortality rates between each group at 30 days, 90 days, 6 months, 1 year, and 2 years (P-value = 0.86). A Kaplan–Meier survival curve demonstrated no difference in survivorship up to 2 years. Older than 65 years, history of hypothyroidism and dementia, and discharge to a skilled nursing facility (SNF) led to increased mortality. There was no survival benefit in treating patients with PPFs with either revision, ORIF, IMN, or a combination of techniques.
Conclusion:. The overall mortality rates observed were 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%), and no differences were found between each group at all follow-up time points. Patients aged 65 and older with a history of hypothyroidism and/or dementia discharged to an SNF are at increased risk for mortality. From a mortality perspective, surgeons should not hesitate to choose the surgical treatment they feel most comfortable performing.
Level of Evidence:. Level III. |
| first_indexed | 2024-04-24T18:50:07Z |
| format | Article |
| id | doaj.art-f001065e0cc24279b2a74be14be0c410 |
| institution | Directory Open Access Journal |
| issn | 2574-2167 |
| language | English |
| last_indexed | 2024-04-24T18:50:07Z |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | OTA International |
| spelling | doaj.art-f001065e0cc24279b2a74be14be0c4102024-03-27T03:42:56ZengWolters KluwerOTA International2574-21672024-03-017110.1097/OI9.0000000000000322OI90000000000000322Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk?Jay K. Shah, DO0Laith Z. Abwini, MS1Alex Tang, MD2Jason I. Yang, BS3David M. Keller, DO4Luke G. Menken, DO5Frank A. Liporace, MD6Richard S. Yoon, MD7Division of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJDivision of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center–RWJBarnabas Health, Jersey City, NJAbstract. Objectives:. To compare mortality rates between patients treated surgically for periprosthetic fractures (PPF) after total hip arthroplasty (THA), total knee arthroplasty (TKA), peri-implant (PI), and interprosthetic (IP) fractures while identifying risk factors associated with mortality following PPF. Design:. Retrospective. Setting:. Single, Level II Trauma Center. Patients/Participants:. A retrospective review was conducted of 129 consecutive patients treated surgically for fractures around a pre-existing prosthesis or implant from 2013 to 2020. Patients were separated into 4 comparison groups: THA, TKA, PI, and IP fractures. Intervention:. Revision implant or arthroplasty, open reduction and internal fixation (ORIF), intramedullary nailing (IMN), percutaneous screws, or a combination of techniques. Main Outcome Measurements:. Primary outcome measures include mortality rates of different types of PPF, PI, and IP fractures at 1-month, 3-month, 6-month, 1-year, and 2-year postoperative. We analyzed risk factors associated with mortality aimed to determine whether treatment type affects mortality. Results:. One hundred twenty-nine patients were included for final analysis. Average follow-up was similar between all groups. The overall 1-year mortality rate was 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%). There were no differences in mortality rates between each group at 30 days, 90 days, 6 months, 1 year, and 2 years (P-value = 0.86). A Kaplan–Meier survival curve demonstrated no difference in survivorship up to 2 years. Older than 65 years, history of hypothyroidism and dementia, and discharge to a skilled nursing facility (SNF) led to increased mortality. There was no survival benefit in treating patients with PPFs with either revision, ORIF, IMN, or a combination of techniques. Conclusion:. The overall mortality rates observed were 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%), and no differences were found between each group at all follow-up time points. Patients aged 65 and older with a history of hypothyroidism and/or dementia discharged to an SNF are at increased risk for mortality. From a mortality perspective, surgeons should not hesitate to choose the surgical treatment they feel most comfortable performing. Level of Evidence:. Level III.http://journals.lww.com/10.1097/OI9.0000000000000322 |
| spellingShingle | Jay K. Shah, DO Laith Z. Abwini, MS Alex Tang, MD Jason I. Yang, BS David M. Keller, DO Luke G. Menken, DO Frank A. Liporace, MD Richard S. Yoon, MD Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? OTA International |
| title | Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? |
| title_full | Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? |
| title_fullStr | Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? |
| title_full_unstemmed | Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? |
| title_short | Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk? |
| title_sort | comparative outcomes after treatment of peri implant periprosthetic and interprosthetic femur fractures which factors increase mortality risk |
| url | http://journals.lww.com/10.1097/OI9.0000000000000322 |
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