The aim of this study was to describe the management and associated outcomes of patients sustaining a femoral hip periprosthetic fracture (PPF) in the UK population. This was a multicentre retrospective cohort study including adult patients who presented to 27 NHS hospitals with 539 new PPFs between 1 January 2018 and 31 December 2018. Data collected included: management strategy (operative and nonoperative), length of stay, discharge destination, and details of post-treatment outcomes (reoperation, readmission, and 30-day and 12-month mortality). Descriptive analysis by fracture type was performed, and predictors of PPF management and outcomes were assessed using mixed-effects logistic regression.Aims
Methods
Periprosthetic femoral fractures (PFF) following total hip arthroplasty
(THA) are devastating complications that are associated with functional
limitations and increased overall mortality. Although cementless
implants have been associated with an increased risk of PFF, the
precise contribution of implant geometry and design on the risk
of both intra-operative and post-operative PFF remains poorly investigated.
A systematic review was performed to aggregate all of the PFF literature
with specific attention to the femoral implant used. A systematic search strategy of several journal databases and
recent proceedings from the American Academy of Orthopaedic Surgeons
was performed. Clinical articles were included for analysis if sufficient
implant description was provided. All articles were reviewed by
two reviewers. A review of fundamental investigations of implant
load-to-failure was performed, with the intent of identifying similar
conclusions from the clinical and fundamental literature.Aims
Patients and Methods
National Institute of Clinical Excellence guidelines
state that cemented stems with an Orthopaedic Data Evaluation Panel
(ODEP) rating of >
3B should be used for hemiarthroplasty when treating
an intracapsular fracture of the femoral neck. These recommendations
are based on studies in which most, if not all stems, did not hold
such a rating. This case-control study compared the outcome of hemiarthroplasty
using a cemented (Exeter) or uncemented (Corail) femoral stem. These
are the two prostheses most commonly used in hip arthroplasty in
the UK. Data were obtained from two centres; most patients had undergone
hemiarthroplasty using a cemented Exeter stem (n = 292/412). Patients
were matched for all factors that have been shown to influence mortality
after an intracapsular fracture of the neck of the femur. Outcome
measures included: complications, re-operations and mortality rates
at two, seven, 30 and 365 days post-operatively. Comparable outcomes
for the two stems were seen. There were more intra-operative complications in the uncemented
group (13% This study therefore supports the use of both cemented and uncemented
stems of proven design, with an ODEP rating of 10A, in patients
with an intracapsular fracture of the neck of the femur. Cite this article:
