The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study

Background: The impact of prior fragility fractures and osteoporosis treatment before total hip arthroplasty (THA) on postoperative complications is unclear. The purpose of this study was to characterize the effect of prior fragility fractures and preoperative osteoporosis treatment on short-term co...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Austin J. Ross, BS, Bailey J. Ross, BA, Olivia C. Lee, MD, George N. Guild, III, MD, William F. Sherman, MD, MBA
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Fragility Fracture Treatment Arthroplasty Hip Osteoporosis Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/54443dbe0d1f4b239a668a2b912a0fe1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:54443dbe0d1f4b239a668a2b912a0fe1
record_format	dspace
spelling	oai:doaj.org-article:54443dbe0d1f4b239a668a2b912a0fe12021-11-14T04:33:50ZThe Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study2352-344110.1016/j.artd.2021.07.008https://doaj.org/article/54443dbe0d1f4b239a668a2b912a0fe12021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001254https://doaj.org/toc/2352-3441Background: The impact of prior fragility fractures and osteoporosis treatment before total hip arthroplasty (THA) on postoperative complications is unclear. The purpose of this study was to characterize the effect of prior fragility fractures and preoperative osteoporosis treatment on short-term complications and secondary fragility fractures after THA. Methods: A propensity score–matched retrospective cohort study was conducted using a commercially available database to (1) characterize the impact of prior fragility fractures on rates of short-term complications after THA and (2) evaluate if osteoporosis treatment before arthroplasty reduces risk of postoperative complications. Rates of periprosthetic fracture, revision THA, and fragility fractures were compared via multivariable logistic regression. Results: After 1:1 propensity score matching, 2188 patients were assigned to each cohort. Patients with a fragility fracture in the 3 years preceding THA were more likely to sustain a periprosthetic fracture (1 year: 1.7% vs 1.0%, odds ratio [OR] 1.89; 2 years: 2.1% vs 1.1%, OR 1.82), fragility fracture (1 year: 4.7% vs 1.1%, OR 3.59; 2 years: 6.7% vs 1.7%, OR 3.21), and revision THA (1 year: 2.7% vs 1.7%, OR 1.65; 2 years: 3.1% vs 1.9%, OR 1.58). Among patients with a prior fragility fracture, only 13.8% received osteoporosis pharmacotherapy before THA. Rates of all complications were statistically comparable postoperatively for patients with and without pre-THA osteoporosis treatment. Conclusions: Fragility fractures within 3 years before THA are associated with significantly increased risk of periprosthetic fracture, all-cause revision, and secondary fragility fractures postoperatively. Preoperative osteoporosis treatment may not decrease risk of postoperative complications.Austin J. Ross, BSBailey J. Ross, BAOlivia C. Lee, MDGeorge N. Guild, III, MDWilliam F. Sherman, MD, MBAElsevierarticleFragilityFractureTreatmentArthroplastyHipOsteoporosisOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 41-48 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fragility Fracture Treatment Arthroplasty Hip Osteoporosis Orthopedic surgery RD701-811
spellingShingle	Fragility Fracture Treatment Arthroplasty Hip Osteoporosis Orthopedic surgery RD701-811 Austin J. Ross, BS Bailey J. Ross, BA Olivia C. Lee, MD George N. Guild, III, MD William F. Sherman, MD, MBA The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
description	Background: The impact of prior fragility fractures and osteoporosis treatment before total hip arthroplasty (THA) on postoperative complications is unclear. The purpose of this study was to characterize the effect of prior fragility fractures and preoperative osteoporosis treatment on short-term complications and secondary fragility fractures after THA. Methods: A propensity score–matched retrospective cohort study was conducted using a commercially available database to (1) characterize the impact of prior fragility fractures on rates of short-term complications after THA and (2) evaluate if osteoporosis treatment before arthroplasty reduces risk of postoperative complications. Rates of periprosthetic fracture, revision THA, and fragility fractures were compared via multivariable logistic regression. Results: After 1:1 propensity score matching, 2188 patients were assigned to each cohort. Patients with a fragility fracture in the 3 years preceding THA were more likely to sustain a periprosthetic fracture (1 year: 1.7% vs 1.0%, odds ratio [OR] 1.89; 2 years: 2.1% vs 1.1%, OR 1.82), fragility fracture (1 year: 4.7% vs 1.1%, OR 3.59; 2 years: 6.7% vs 1.7%, OR 3.21), and revision THA (1 year: 2.7% vs 1.7%, OR 1.65; 2 years: 3.1% vs 1.9%, OR 1.58). Among patients with a prior fragility fracture, only 13.8% received osteoporosis pharmacotherapy before THA. Rates of all complications were statistically comparable postoperatively for patients with and without pre-THA osteoporosis treatment. Conclusions: Fragility fractures within 3 years before THA are associated with significantly increased risk of periprosthetic fracture, all-cause revision, and secondary fragility fractures postoperatively. Preoperative osteoporosis treatment may not decrease risk of postoperative complications.
format	article
author	Austin J. Ross, BS Bailey J. Ross, BA Olivia C. Lee, MD George N. Guild, III, MD William F. Sherman, MD, MBA
author_facet	Austin J. Ross, BS Bailey J. Ross, BA Olivia C. Lee, MD George N. Guild, III, MD William F. Sherman, MD, MBA
author_sort	Austin J. Ross, BS
title	The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
title_short	The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
title_full	The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
title_fullStr	The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
title_full_unstemmed	The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study
title_sort	impact of prior fragility fractures on complications after total hip arthroplasty: a propensity score–matched cohort study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/54443dbe0d1f4b239a668a2b912a0fe1
work_keys_str_mv	AT austinjrossbs theimpactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT baileyjrossba theimpactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT oliviacleemd theimpactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT georgenguildiiimd theimpactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT williamfshermanmdmba theimpactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT austinjrossbs impactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT baileyjrossba impactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT oliviacleemd impactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT georgenguildiiimd impactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy AT williamfshermanmdmba impactofpriorfragilityfracturesoncomplicationsaftertotalhiparthroplastyapropensityscorematchedcohortstudy
_version_	1718429956771414016

The Impact of Prior Fragility Fractures on Complications After Total Hip Arthroplasty: A Propensity Score–Matched Cohort Study

Ejemplares similares