$Risk factors of early periprosthetic femoral fracture after total knee arthroplasty$
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Risk factors of early periprosthetic femoral fracture after total knee arthroplasty

Abstract Background Periprosthetic femoral fracture (PFF) is a serious complication after total knee arthroplasty (TKA). However, the risk factors of PFF in the early postoperative setting are not well documented. This study determines the risk factors of early PFF after primary TKA. Methods This st...

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Autores principales:	Chaturong Pornrattanamaneewong, Akraporn Sitthitheerarut, Pakpoom Ruangsomboon, Keerati Chareancholvanich, Rapeepat Narkbunnam
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Risk factor Periprosthetic fracture Total knee arthroplasty Age Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/76f2de7259644522af8f4181d6b07e5f
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spelling	oai:doaj.org-article:76f2de7259644522af8f4181d6b07e5f2021-12-05T12:18:29ZRisk factors of early periprosthetic femoral fracture after total knee arthroplasty10.1186/s12891-021-04875-51471-2474https://doaj.org/article/76f2de7259644522af8f4181d6b07e5f2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04875-5https://doaj.org/toc/1471-2474Abstract Background Periprosthetic femoral fracture (PFF) is a serious complication after total knee arthroplasty (TKA). However, the risk factors of PFF in the early postoperative setting are not well documented. This study determines the risk factors of early PFF after primary TKA. Methods This study recruited 24 patients who had early PFF within postoperative 3 months and 96 control patients. Demographic data (age, gender, weight, height, body mass index, Deyo-Charlson comorbidity index, diagnosis, operated side, underlying diseases and history of steroid usage intraoperative outcomes), intraoperative outcomes (operative time, surgical approach, type and brand of the prosthesis), and radiographic outcomes (distal femoral width; DFW, prosthesis-distal femoral width ratio; PDFW ratio, anatomical lateral distal femoral angle; LDFA, the change of LDFA, femoral component flexion angle; FCFA and anterior femoral notching; AFN) were recorded and compared between groups. Details of PFF, including fracture pattern, preoperative deformity, and time to PFF were also documented. Results In univariate analysis, the PFF group had significantly older, right side injury, rheumatoid, dyslipidemia, Parkinson patients than the control group (p < 0.05). No cruciate-retaining design was used in PFF group (p = 0.004). Differences between the prosthetic brand used were found in this study (p = 0.049). For radiographic outcomes, PFF group had significantly lower DFW but higher PDFW ratio and postoperative LDFA than the control group (p < 0.05). While the change of LDFA, FCFA and AFN were similar between groups. The fracture patterns were medial condylar (45.8%), lateral condylar (25.0%) and supracondylar fracture (29.2%). The mean overall time to PFF was 37.2 ± 20.6 days (range 8–87 days). Preoperative deformity was significantly different among the three patterns (p < 0.05). When performed multivariate analysis using the logistic regression model, age was only an independent risk factor for early PFF. The cut-off point of age was > = 75 years, with a sensitivity of 75.0% and specificity of 78.1%. Conclusion This study determined that age was the independent risk factors for early PFF. However, further well-controlled studies with a larger sample size were needed to address this issue.Chaturong PornrattanamaneewongAkraporn SitthitheerarutPakpoom RuangsomboonKeerati ChareancholvanichRapeepat NarkbunnamBMCarticleRisk factorPeriprosthetic fractureTotal knee arthroplastyAgeDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Risk factor Periprosthetic fracture Total knee arthroplasty Age Diseases of the musculoskeletal system RC925-935
spellingShingle	Risk factor Periprosthetic fracture Total knee arthroplasty Age Diseases of the musculoskeletal system RC925-935 Chaturong Pornrattanamaneewong Akraporn Sitthitheerarut Pakpoom Ruangsomboon Keerati Chareancholvanich Rapeepat Narkbunnam Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
description	Abstract Background Periprosthetic femoral fracture (PFF) is a serious complication after total knee arthroplasty (TKA). However, the risk factors of PFF in the early postoperative setting are not well documented. This study determines the risk factors of early PFF after primary TKA. Methods This study recruited 24 patients who had early PFF within postoperative 3 months and 96 control patients. Demographic data (age, gender, weight, height, body mass index, Deyo-Charlson comorbidity index, diagnosis, operated side, underlying diseases and history of steroid usage intraoperative outcomes), intraoperative outcomes (operative time, surgical approach, type and brand of the prosthesis), and radiographic outcomes (distal femoral width; DFW, prosthesis-distal femoral width ratio; PDFW ratio, anatomical lateral distal femoral angle; LDFA, the change of LDFA, femoral component flexion angle; FCFA and anterior femoral notching; AFN) were recorded and compared between groups. Details of PFF, including fracture pattern, preoperative deformity, and time to PFF were also documented. Results In univariate analysis, the PFF group had significantly older, right side injury, rheumatoid, dyslipidemia, Parkinson patients than the control group (p < 0.05). No cruciate-retaining design was used in PFF group (p = 0.004). Differences between the prosthetic brand used were found in this study (p = 0.049). For radiographic outcomes, PFF group had significantly lower DFW but higher PDFW ratio and postoperative LDFA than the control group (p < 0.05). While the change of LDFA, FCFA and AFN were similar between groups. The fracture patterns were medial condylar (45.8%), lateral condylar (25.0%) and supracondylar fracture (29.2%). The mean overall time to PFF was 37.2 ± 20.6 days (range 8–87 days). Preoperative deformity was significantly different among the three patterns (p < 0.05). When performed multivariate analysis using the logistic regression model, age was only an independent risk factor for early PFF. The cut-off point of age was > = 75 years, with a sensitivity of 75.0% and specificity of 78.1%. Conclusion This study determined that age was the independent risk factors for early PFF. However, further well-controlled studies with a larger sample size were needed to address this issue.
format	article
author	Chaturong Pornrattanamaneewong Akraporn Sitthitheerarut Pakpoom Ruangsomboon Keerati Chareancholvanich Rapeepat Narkbunnam
author_facet	Chaturong Pornrattanamaneewong Akraporn Sitthitheerarut Pakpoom Ruangsomboon Keerati Chareancholvanich Rapeepat Narkbunnam
author_sort	Chaturong Pornrattanamaneewong
title	Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
title_short	Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
title_full	Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
title_fullStr	Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
title_full_unstemmed	Risk factors of early periprosthetic femoral fracture after total knee arthroplasty
title_sort	risk factors of early periprosthetic femoral fracture after total knee arthroplasty
publisher	BMC
publishDate	2021
url	https://doaj.org/article/76f2de7259644522af8f4181d6b07e5f
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_version_	1718372081169596416

Risk factors of early periprosthetic femoral fracture after total knee arthroplasty

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