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A Retrospective Study on the Incidence of Periprosthetic Fractures Related to Total Hip Arthroplasty and
Victor Niculescu1, Delia Carmen Nistor-Cseppento2,3, Sebastian Tirla2,3
1Doctoral School, University of Medicine and Pharmacy "Carol Davila" Bucuresti, 050074 București, Romania.
Insights
Periprosthetic fractures (PFs) after hip replacement are increasing, especially in older adults. While age is a significant predictor of PFs, it shows a weak link to immediate post-surgical complications.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Public Health
Background:
- Periprosthetic fractures (PFs) are significant complications following total hip arthroplasty (THA).
- Elderly patients with comorbidities and low bone density are particularly vulnerable.
- Vancouver classification guides surgical treatment (internal fixation or revision arthroplasty).
Purpose of the Study:
- To determine the annual incidence of PFs after THA.
- To analyze in-hospital complications associated with PFs.
- To evaluate the predictive role of age in PF occurrence and complications.
Main Methods:
- Retrospective observational study (2021-2023).
- Analysis of 783 patients undergoing hip surgery at Bihor County Emergency Hospital.
- Statistical analysis including correlation and linear regression.
Main Results:
- PF incidence was 4.5% (38 cases out of 768 surgeries).
- Vancouver B fractures were most common, treated primarily with internal fixation.
- In-hospital complications occurred in 23.68% of PF cases, with a 7.90% mortality rate.
- Age was a statistically significant predictor of PF incidence (explaining 2.7% variability), but showed a weak, non-significant association with post-surgical complications.
Conclusions:
- Rising THA rates and an aging population contribute to increased PFs.
- PFs are more prevalent in elderly women, with no significant sex-based difference in incidence.
- Age is a key factor in PF development, necessitating targeted prevention strategies.
Abstract:
Background/Objectives: Periprosthetic fractures (PFs) are serious complications that can occur after total hip arthroplasty (THA), particularly in elderly patients who often have multiple comorbidities and low bone density. The surgical treatment of PFs typically involves internal fixation or revision arthroplasty, depending on the fracture type categorized by the Vancouver classification. This study examines the annual incidence of PFs and the complications that arise during hospitalization, as well as the predictive role of age in the occurrence of these fractures and their associated complications. Methods: Based on a retrospective observational study conducted over three years (2021-2023) at the Bihor County Emergency Hospital in Oradea, we analyzed 783 patients who underwent various hip surgeries. Results: The retrospective analysis identified 38 cases of PF out of 768 hip surgeries, resulting in an incidence of PF of 4.5%. Most PFs were classified as Vancouver B, with surgeries mainly involving internal fixation. Complications occurred in 23.68% of cases, including a mortality rate of 7.90%. A correlation analysis examining the relationship between age and post-surgical complications demonstrates a weak and statistically insignificant association (r = 0.120, p = 0.478). To highlight whether age is a predictive factor for PFs, we used the linear regression model; this suggests that older age explains 2.7% of the total variability in the incidence of PFs, being statistically significant ([F(1, 766) = 20.923], p < 0.001). Conclusions: The rising incidence of periprosthetic fractures is closely linked to the increasing number of total hip arthroplasties and the aging population. Fractures of this type are more common in elderly women, with no statistically significant differences have been found between the sexes.
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