Differences in Perioperative Outcomes Between Conversion Total Hip Arthroplasty After Previous Proximal Femur Fracture and Primary Total Hip Arthroplasty

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-05-24 DOI:10.1016/j.artd.2025.101715

Brook Biniam BSc , Jonathan Bourget-Murray MD , Paul Beaulé MD , Paul Kim MD , Wade Gofton MD , George Grammatopoulos MBBS, DPhil

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引用次数: 0

Abstract

Background

This study compares outcomes between conversion total hip arthroplasty (THA) after proximal femur fracture (PFF) fixation and primary THA for osteoarthritis and examines whether fracture type affects results.

Methods

This is a retrospective review of prospectively collected data from a single academic center. Eighty-seven consecutive patients underwent conversion THA following surgical fixation of a PFF with a minimum 2-year follow-up. These patients were matched 1:1 with patients who underwent a primary THA for osteoarthritis, by the same arthroplasty surgeons, using propensity score technique. Outcomes measures included length of stay, complications, reoperation rates, and Oxford Hip Score (OHS). Subgroup analysis involved comparing outcome measures between patients who required conversion THA following an intracapsular and extracapsular PFF.

Results

The mean follow-up was 5.6 years (range, 2.3-13.1). Patients in the conversion THA group required longer length of stay (8.1 vs 1.4 days, P < .001). There was no difference in complication rate (12.6% vs 16.1%, P = .491), reoperative rate (12.6% vs 5.7%, P = .243), or OHS (40.1 vs 37.2; P = .052) at final follow-up. There was no difference in outcomes between controls and conversion THA for a previous intracapsular PFF. Reoperation rate was significantly higher (18.2% vs 5.7%, P = .039) and OHS significantly lower (32.3 vs 40.0, P < .001) for conversion THA following extracapsular PFF.

Conclusions

Conversion THA after extracapsular PPF is associated with higher reoperation rates and poorer functional outcomes than primary THA for osteoarthritis. In contract, intracapsular PPF show comparable results, underscoring the need to consider fracture type in treatment planning.

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股骨近端骨折后行全髋关节置换术与初次全髋关节置换术围手术期疗效的差异

背景：本研究比较了股骨近端骨折（PFF）固定后置换全髋关节置换术（THA）和原发性全髋关节置换术治疗骨关节炎的结果，并探讨了骨折类型是否影响结果。方法回顾性分析来自单一学术中心的前瞻性数据。87例连续患者在手术固定PFF后接受了置换THA，随访至少2年。使用倾向评分技术，这些患者与接受原发性骨关节炎THA手术的患者进行1:1的匹配。结果测量包括住院时间、并发症、再手术率和牛津髋关节评分（OHS）。亚组分析包括比较在囊内和囊外PFF后需要转换THA的患者之间的结果测量。结果平均随访5.6年（范围2.3 ~ 13.1年）。转换THA组患者需要更长的住院时间(8.1天vs 1.4天，P <；措施)。并发症发生率（12.6%比16.1%,P = .491）、再手术率（12.6%比5.7%,P = .243）、OHS(40.1比37.2；P = .052)。既往囊内PFF的对照组和转化THA之间的结果没有差异。再手术率明显高于对照组（18.2% vs 5.7%, P = 0.039）， OHS明显低于对照组(32.3 vs 40.0, P <；.001)用于囊外PFF后的THA转换。结论骨关节炎患者囊外置换术后再手术率较高，功能预后较原发性THA差。相比之下，囊内PPF显示出类似的结果，强调了在治疗计划中考虑骨折类型的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.