Patients with trochanteric hip fractures and pre-existing osteoarthritis can be treated with nailing osteosynthesis...

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Radiology

Background:

• Hip osteoarthritis (OA) prevalence increases with age.
• Functional outcomes after trochanteric fracture fixation in patients with pre-existing OA are not well-defined.
• Optimizing treatment for this demographic can reduce socioeconomic burden.

Purpose of the Study:

• To analyze the influence of pre-existing radiographic hip OA on functional outcomes after trochanteric fracture fixation.
• To compare functional recovery in patients with and without OA at one-year follow-up.
• To identify potential factors influencing treatment decisions and patient independence.

Main Methods:

• Retrospective analysis of patients undergoing proximal femoral nailing for trochanteric fracture.
• Grading of hip OA using the Tonnis classification.
• Assessment of functional outcome via the Parker Mobility Score (PMS) preoperatively and 12 months post-surgery.
• Competing risk regression analysis adjusting for confounders, with death as a competing event.

Main Results:

• 80 out of 375 patients (21%) had pre-existing OA (Tonnis 2 or 3) and were older on average.
• Mean PMS reduction at 12 months was 1.3 in OA patients vs. 1.07 in non-OA patients (p=0.43).
• No significant differences were observed in death, reoperations, readmissions, surgical time, or fracture reduction quality between groups.

Conclusions:

• Pre-existing radiographic OA did not lead to significantly worse functional outcomes one year after trochanteric fracture fixation with femoral nailing.
• Further research is warranted to compare femoral nailing with arthroplasty for treating trochanteric fractures in OA patients.